De Boer E J, Van Leeuwen F E, Den Tonkelaar I, Jansen C A M, Braat D D M, Burger C W
Nederlands Kanker Instituut-Antoni van Leeuwenhoek Zickenhuis, afd. Epidemiologie, Plesmanlaan 12 1, 1066 CX Amsterdam.
Ned Tijdschr Geneeskd. 2004 Jul 17;148(29):1448-55.
To describe methods and results of in-vitro fertilisation (IVF) treatment during the first 12 years after the introduction of IVF treatment in the Netherlands. Design. Retrospective cohort study.
A nationwide study was conducted among women who had had their first IVF cycle stimulated with gonadotrophins in 12 IVF centres in the Netherlands in the period 1 January 1983 to 31 December 1994 (n = 8, 184).
The subfertility diagnosis related to tubal factors decreased from 70% in 1987 to 25% in 1994. The subfertility diagnosis related to a male factor increased from 8.7% in 1987 to 35.5% in 1994. The mean age at first IVF treatment remained roughly constant. During the introduction of GnRH agonists there was an increase in gonadotrophin dosages, the number of retrieved oocytes, the number of high responders and/or women who experienced an ovarian hyperstimulation syndrome (OHSS). The percentage of deliveries with at least one baby born alive after the first IVF cycle increased from 6% in 1984 to 18% in 1994. The number of live births per 100 transferred embryos increased from 2.5 in 1985 to 12 in 1994. Furthermore, the mean numbers of embryos transferred after the first IVF cycle decreased from 3.2 in 1987 to 2.2 in 1994. The overall success rate - defined as the proportion of women who had at least one child born alive after one or more IVF cycles - for women who had their first IVF treatment between 1983 and 1994 was 37.1%. The percentage of triplets or quadruplets decreased from 8.7 in 1989 to 1.2 in 1994. The percentage of twin deliveries remained about 25.
The introduction of GnRH agonists and the higher dosages of gonadotrophins led to a higher oocyte harvest. During the first years of IVF treatment there was an increase in the success rate after the first treatment cycle. The overall success rate remained constant after 1991. The risk of developing an OHSS increased whereas the rate of twin deliveries remained constant.
描述荷兰引入体外受精（IVF）治疗后的头12年中IVF治疗的方法和结果。设计：回顾性队列研究。
对1983年1月1日至1994年12月31日期间在荷兰12个IVF中心接受首次使用促性腺激素刺激的IVF周期的女性进行了一项全国性研究（n = 8,184）。
与输卵管因素相关的亚生育诊断从1987年的70%降至1994年的25%。与男性因素相关的亚生育诊断从1987年的8.7%增至1994年的35.5%。首次IVF治疗时的平均年龄大致保持不变。在引入促性腺激素释放激素（GnRH）激动剂期间，促性腺激素剂量、回收的卵母细胞数量、高反应者和/或经历卵巢过度刺激综合征（OHSS）的女性数量有所增加。首次IVF周期后至少有一个活产婴儿的分娩百分比从1984年的6%增至1994年的18%。每100个移植胚胎的活产婴儿数量从1985年的2.5增至1994年的12。此外，首次IVF周期后移植的胚胎平均数量从1987年的3.2降至1994年的2.2。1983年至1994年接受首次IVF治疗的女性的总体成功率（定义为在一个或多个IVF周期后至少有一个活产子女的女性比例）为37.1%。三胞胎或四胞胎的百分比从1989年的8.7降至1994年的1.2。双胞胎分娩的百分比保持在约25%。
GnRH激动剂的引入和更高剂量的促性腺激素导致了更高的卵母细胞收获量。在IVF治疗的头几年，首次治疗周期后的成功率有所提高。1991年后总体成功率保持不变。发生OHSS的风险增加，而双胞胎分娩率保持不变。
