Macklon N S, Fauser B C
Erasmus Medisch Centrum, Centrum voor Voortplantingsgeneeskunde, Dr. Molewaterplein 40, 3015 GD Rotterdam.
Ned Tijdschr Geneeskd. 2003 Jul 5;147(27):1301-4.
In order to obtain high pregnancy rates per IVF cycle, ovarian stimulation is employed to produce multiple embryos. The best embryos are transferred into the uterus and the remainder are frozen for possible use in later cycles. Despite limiting the number of transferred embryos, more than half of all IVF babies are the result of multiple pregnancies. The associated morbidity and costs have led to calls for the adoption of single embryo transfer. New techniques such as pre-implantation genetic screening for aneuploidy have enabled better embryo selection with optimal chances of a healthy child. Milder ovarian stimulation protocols may further reduce the morbidity and costs of IVF cycles. Improved cryopreservation techniques should improve the chances of pregnancies in subsequent cycles using excess embryos. The definition of success in IVF should be changed from number of children per IVF cycle to number of children born after singleton pregnancies per IVF treatment started.
为了在每个体外受精(IVF)周期获得高妊娠率,采用卵巢刺激来产生多个胚胎。将最佳胚胎移植到子宫内,其余胚胎冷冻以备后续周期使用。尽管限制了移植胚胎的数量,但所有IVF婴儿中仍有超过一半是多胎妊娠的结果。相关的发病率和成本促使人们呼吁采用单胚胎移植。诸如非整倍体植入前基因筛查等新技术能够更好地选择胚胎,从而使生出健康孩子的机会达到最佳。较温和的卵巢刺激方案可能会进一步降低IVF周期的发病率和成本。改进的冷冻保存技术应能提高使用多余胚胎进行后续周期妊娠的机会。IVF成功的定义应从每个IVF周期的孩子数量转变为每开始一次IVF治疗后单胎妊娠出生的孩子数量。