Borkenhagen A, Brähler E, Kentenich H
Department of Medical Psychology and Medical Sociology, University of Leipzig Philipp-Rosenthal Street 55, Leipzig, Germany.
Hum Reprod. 2007 Nov;22(11):2883-7. doi: 10.1093/humrep/dem296. Epub 2007 Sep 26.
In Germany, embryo screening programmes combined with elective embryo transfer are illegal, but there is controversial debate about their legalization. Studies about the attitudes of infertile couples towards multiples, elective embryo transfer and multifetal reduction may help to illuminate how this law shapes patient choices.
A survey of 265 German infertile couples was conducted. Different logistic regression analyses were performed to assess independent factors associated with the parity for multiple births, approval for elective embryo transfer and multifetal reduction.
Despite prior information about the risk of multiple births, 81% of respondents saw no risk in twin pregnancies and a sizable minority saw no risk even in triplet pregnancies. Eighty-nine percent of the respondents rated a twin pregnancy as desirable, whereas 35% rated a triplet birth as desirable. When presented with a choice of having multiple births versus having no biological children, 99% of the respondents endorsed twins, 84% triplets and 58% quadruplets. Seventy-four percent of the respondents approve of legalizing embryo screening programmes to select a good-quality embryo combined with elective embryo transfer. Ninety-two percent of the respondents rejected fetal reduction of twins.
German infertile couples might conceivably be more willing to accept elective embryo transfer if screening for viable embryos was permitted.
在德国,胚胎筛查项目与选择性胚胎移植相结合是非法的,但关于其合法化存在争议性辩论。对不孕夫妇关于多胎妊娠、选择性胚胎移植和多胎减胎的态度进行研究,可能有助于阐明这项法律如何影响患者的选择。
对265对德国不孕夫妇进行了一项调查。进行了不同的逻辑回归分析,以评估与多胎分娩的胎次、对选择性胚胎移植和多胎减胎的认可相关的独立因素。
尽管事先了解了多胎妊娠的风险,但81%的受访者认为双胎妊娠没有风险,相当一部分少数人甚至认为三胎妊娠也没有风险。89%的受访者认为双胎妊娠是理想的,而35%的受访者认为三胎分娩是理想的。当面临多胎分娩与没有亲生孩子的选择时,99%的受访者支持双胎,84%支持三胎,58%支持四胎。74%的受访者赞成将胚胎筛查项目合法化,以选择优质胚胎并结合选择性胚胎移植。92%的受访者拒绝减胎双胎。
如果允许对存活胚胎进行筛查,德国不孕夫妇可能会更愿意接受选择性胚胎移植。