Wennerholm U B, Bergh C
Department of Obstetrics and Gynecology, Institute for the Health of Women and Children, Sahlgrenska University Hospital, East, 416 85 Göteborg, Sweden.
Hum Reprod. 2004 Sep;19(9):1943-5. doi: 10.1093/humrep/deh392. Epub 2004 Jul 8.
An intensive debate is ongoing in this journal concerning the most appropriate endpoint after assisted reproduction techniques. The endpoint suggested by the first authors was Birth Emphasizing a Successful Singleton at Term (BESST). We have evaluated the most appropriate endpoint from different perspectives: patients, public, health authorities, obstetric and IVF clinics. We find singleton live birth highly relevant as an outcome parameter as multiple pregnancies are the main factor responsible for the overall poorer obstetric and neonatal outcome in IVF pregnancies, and multiple pregnancies are mostly an avoidable iatrogenic complication. However, our proposal is that both preterm and term singletons should be included since the prematurity rate is an outcome that is largely uninfluenced by the IVF clinics. In conclusion, we propose singleton live birth per cycle initiated as the most appropriate main outcome after assisted reproduction. Prematurity should in addition be reported separately as a secondary outcome.
本期刊正在就辅助生殖技术后最合适的终点指标展开激烈辩论。第一作者提出的终点指标是足月单胎活产成功分娩（BESST）。我们从不同角度评估了最合适的终点指标：患者、公众、卫生当局、产科和试管婴儿诊所。我们发现单胎活产作为一个结果参数具有高度相关性，因为多胎妊娠是试管婴儿妊娠中导致总体产科和新生儿结局较差的主要因素，而且多胎妊娠大多是一种可避免的医源性并发症。然而，我们的建议是应将早产和足月单胎都包括在内，因为早产率在很大程度上不受试管婴儿诊所的影响。总之，我们提议将每个启动周期的单胎活产作为辅助生殖后最合适的主要结局。此外，早产应作为次要结局单独报告。
