Barros Delgadillo Juan Carlos, Alvarado Méndez Luz María, Gorbea Chávez Viridiana, Villalobos Acosta Sergio, Sánchez Solís Víctor, Gaviño Gaviño Fernando
Departamento de Reproducción Asistida, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Lomas de Virreyes, CP, México, DF.
Ginecol Obstet Mex. 2006 Dec;74(12):626-39.
In 1978 the first successfull birth by in vitro fertilization took place and this assisted reproduction technique became alternative of treatment in the couples with infertility that had not obtained pregnancy with conventional treatments. The conditions of clinical treatment and laboratory improved, which were in greater number of pregnancies. In 1985 the first study was published that showed adverse perinatal results in pregnancies obtained with fertilization in vitro. Some researchers attributed these results to the increase in the number of multiple pregnancies, pregnant patients older than 35 years, and to the antecedents of infertility.
To compare the perinatal outcomes of pregnancies obtained by in vitro IVFET vs spontaneous pregnancies.
A retrospective, case-control study. All pregnancies obtained after IVF ET from October 1st 1999 to November 30th 2004 were compared with a control group of naturally conceived pregnancies and matched by maternal age and the number of fetus. Data concerning obstetric complications and perinatal outcomes were recorded and matched with their control.
We analyzed 26 vs 52 singleton, 10 vs 20 twins, 5 vs 5 triplet pregnancies, there were no controls for the quadruplet and quintuplet pregnancies. The mean gestational age at delivery and Capurro score in the singleton pregnancies were 37.8 vs 38.8 y 38.2 vs 39.4 weeks for the study and control groups respectively (p < 0.05), the female sex was more frequent in singleton pregnancies obtained by FIVTE (p < 0.05). There were no statistically significant difference in the premature rupture of membranes, preterm labor, preeclampsia, gestational diabetes, placenta accreta, preterm delivery and low birth weight. The mean birth weight of the pregnancies obtained by IVF were of 2,962.8, 2,100 and 1,532 g for singleton, twin, and triplet respectively. A higher incidence of preterm delivery was found in twin pregnancies but it was not statistically significant.
The rates of adverse perinatal outcomes of the pregnancies after IVF were not higher than pregnancies conceived spontaneously. Twin pregnancies have a greater risk to cause preterm delivery not related to the IVFET procedure.
1978年首次通过体外受精成功分娩,这种辅助生殖技术成为那些采用传统治疗方法未能怀孕的不孕夫妇的替代治疗手段。临床治疗和实验室条件得到改善,怀孕的数量增多。1985年发表了第一项研究,显示体外受精获得的妊娠存在不良围产期结局。一些研究人员将这些结果归因于多胎妊娠数量的增加、35岁以上的怀孕患者以及不孕史。
比较体外受精胚胎移植(IVFET)获得的妊娠与自然妊娠的围产期结局。
一项回顾性病例对照研究。将1999年10月1日至2004年11月30日期间IVF ET后获得的所有妊娠与自然受孕妊娠的对照组进行比较,并按产妇年龄和胎儿数量进行匹配。记录有关产科并发症和围产期结局的数据,并与对照组进行匹配。
我们分析了26例单胎妊娠与52例对照,10例双胎妊娠与20例对照,5例三胎妊娠与5例对照,四胎和五胎妊娠没有对照组。单胎妊娠的平均分娩孕周和卡普罗评分在研究组和对照组中分别为37.8周对38.8周以及38.2分对39.4分(p<0.05),通过FIVTE获得的单胎妊娠中女性更为常见(p<0.05)。胎膜早破、早产、子痫前期、妊娠期糖尿病、胎盘植入、早产和低出生体重方面没有统计学上的显著差异。IVF获得的妊娠中单胎、双胎和三胎的平均出生体重分别为2962.8克、2100克和1532克。双胎妊娠中早产发生率较高,但无统计学意义。
IVF后妊娠的不良围产期结局发生率并不高于自然受孕妊娠。双胎妊娠导致早产的风险更大,这与IVFET程序无关。