Twenty years' experience with the Swiss data registry for assisted reproductive medicine: outcomes, key trends and recommendations for improved practice
Twenty years' experience with the Swiss data registry for assisted reproductive medicine: outcomes, key trends and recommendations for improved practice
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DOI：
10.4414/smw.2015.14087
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发表时间：
2015-02-06
影响因子：
2.9
通讯作者：
von Wolff, Michael
中科院分区：
文献类型：
--
作者：
De Geyter, Christian;Fehr, Peter;von Wolff, Michael
研究中的问题：辅助生殖技术（ART）对瑞士人口的影响得到了量化。从 1993 年到 2012 年，ART 产生的交付数量（包括多次交付）与总体交付数量进行了比较。瑞士 ART 专家达成共识，以提高成功结果，减少 ART 并发症的发生率，并通过对现有数据进行统计审查来验证建议。方法：将 1993 年至 2012 年期间生成并由联邦统计局 (BfS) 发布的数据与瑞士生殖医学学会 (SGRM) 组织的瑞士 ART 数据库 (FIVNAT-CH) 进行比较。从这些分析中，瑞士 ART 专家小组提出了改进当前实践、预防 ART 相关并发症的建议，并建议修改瑞士现行有关 ART 的立法。 结果：自 1993 年以来，随着要求接受 ART 的妇女人数增加，女性分娩年龄也随之上升。这种人口趋势反映在ART分娩数量的增加（2012年：2.2%）和多胞胎比例的增加（2012年：17.6%）。 ART 的结果受治疗患者年龄的负面影响最大。回收卵母细胞的数量对分娩的可能性、多胞胎风险和卵巢过度刺激综合征的发生率产生决定性影响。结论：最佳卵巢刺激方案应设计为每次治疗回收 10 至 15 个卵母细胞。瑞士立法应启用并刺激选择性单胚胎移植政策，以避免多胞胎。
QUESTIONS UNDER STUDY: The impact of assisted reproductive technology (ART) on Swiss demography was quantified. From 1993 to 2012 the number of deliveries, including multiples, generated by ART was compared with overall delivery numbers. Swiss experts in ART collaborated in a consensus to increase successful outcomes, to reduce the incidence of complications of ART and to validate recommendations through statistical review of available data.METHODS: Data generated between 1993 and 2012 and published by the Federal Office of Statistics (BfS) were compared with the Swiss database on ART (FIVNAT-CH) as organised by the Swiss Society of Reproductive Medicine (SGRM). From these analyses a panel of Swiss experts in ART extracted recommendations to improve current practice, to prevent complications related to ART and to recommend changes in current Swiss legislation dealing with ART.RESULTS: Since 1993 the age of women giving birth rose together with the number of women asking for ART. This demographic trend was reflected in a rise in the number of deliveries generated by ART (in 2012: 2.2%) and the proportion of multiple births (in 2012: 17.6%). The outcome of ART was most negatively influenced by the age of the treated patient. The number of retrieved oocytes decisively impacted the likelihood of delivery, the risk of multiple births and the incidence of ovarian hyperstimulation syndrome.CONCLUSIONS: Optimal ovarian stimulation should be designed for the retrieval of 10 to 15 oocytes per treatment. Swiss legislation should enable and stimulate a policy of elective single embryo transfer to avoid multiple births.