Van Royen E, Mangelschots K, De Neubourg D, Valkenburg M, Van de Meerssche M, Ryckaert G, Eestermans W, Gerris J
Fertility Clinic, Department of Obstetrics-Gynaecology-Fertility, Middelheim Hospital, Lindendreef 1, 2020 Antwerp, Belgium.
Hum Reprod. 1999 Sep;14(9):2345-9. doi: 10.1093/humrep/14.9.2345.
In most in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) programmes approximately one ongoing pregnancy in three is multiple. The need to characterize embryos with optimal implantation potential is obvious. We retrospectively examined all of 23 double transfers resulting in ongoing twins, occurring between January 1, 1996 and May 19, 1997. Characteristics of these top quality embryos were absence of multinucleated blastomeres, four or five blastomeres on day 2, seven or more cells on day 3, and </=20% anucleated fragments. In a subsequent series of 400 IVF/ICSI cycles (out of which 372 were selected for embryo transfer) from May 20, 1997 to July 31, 1998, only women <38 years of age had multiple pregnancies: after 221 transfers of two embryos, 45/116 (39%) were multiple, and after 77 transfers of >2 embryos, 11/31 (35%) were multiple. We applied our top quality criteria to the 221 double transfers: 106 transfers with two top embryos resulted in 65 (63%) ongoing pregnancies with 37 (57%) twins, 65 transfers with one top embryo in 38 (58%) ongoing pregnancies with eight (21%) twins. In the group without top embryos, 12/52 (23%) ongoing singletons occurred, with no twins. The corresponding ongoing implantation rates were 49, 35 and 12%. This analysis suggests that single embryo transfer with an acceptable pregnancy rate might be considered if a top quality embryo is available.
在大多数体外受精（IVF）/卵胞浆内单精子注射（ICSI）程序中，大约每三次持续妊娠就有一次是多胎妊娠。显然有必要对具有最佳着床潜力的胚胎进行特征描述。我们回顾性研究了1996年1月1日至1997年5月19日期间发生的所有23例导致持续双胎妊娠的双胚胎移植。这些优质胚胎的特征是没有多核卵裂球，第2天有4或5个卵裂球，第3天有7个或更多细胞，以及无核碎片≤20%。在随后1997年5月20日至1998年7月31日的400个IVF/ICSI周期（其中372个被选择进行胚胎移植）中，只有年龄小于38岁的女性有多胎妊娠：在221次双胚胎移植后，45/116（39%）是多胎妊娠，在77次移植超过2个胚胎后，11/31（35%）是多胎妊娠。我们将优质标准应用于221次双胚胎移植：106次移植两个优质胚胎导致65例（63%）持续妊娠，其中37例（57%）为双胎妊娠，65次移植一个优质胚胎导致38例（58%）持续妊娠，其中8例（21%）为双胎妊娠。在没有优质胚胎的组中，出现了12/52（23%）的持续单胎妊娠，没有双胎妊娠。相应的持续着床率分别为49%、35%和12%。该分析表明，如果有优质胚胎，可考虑进行单胚胎移植并获得可接受的妊娠率。
