Unidad de Reproducción, HU Virgen de las Nieves, Granada, Spain.
Reprod Biomed Online. 2009 Dec;19(6):872-8. doi: 10.1016/j.rbmo.2009.09.028.
The aim of this study was to analyse the influence of the type of service provided by assisted reproduction clinics. The activities, treatment patterns and results achieved by assisted reproduction centres in Spain were examined, comparing public and private clinics. A retrospective study was carried out using the Assisted Reproductive Technology Register of the Spanish Fertility Society for 2002-2004. The results showed that 74%, 96% and 99% of IVF/intracytoplasmic sperm injection, oocyte donation and preimplantation genetic diagnosis cycles, respectively, were carried out in the private sector. Public clinics performed proportionally more transfers of three embryos than the private clinics (48.1% versus 41.7%). More elective transfers were performed in private clinics. Pregnancy rates per cycle started, per puncture and per transfer were significantly higher among private than public clinics (29.1%, 32.7% and 35.9% versus 25.2%, 28.5% and 32.6%, respectively) (P < 0.05). Implantation rate has risen year on year in both types of clinic and was significantly higher (P < 0.05), every year, among the private clinics. The multiple-pregnancy rate was significantly higher among the private clinics (30.8% versus 26.4%) (P < 0.05). In conclusion, differences exist between public and private clinics as regards to their volume of activity, the range of services offered, clinical practice and results achieved.
本研究旨在分析提供辅助生殖诊所服务类型的影响。研究考察了西班牙辅助生殖中心的活动、治疗模式和所取得的成果，并比较了公立和私立诊所。这项回顾性研究使用了西班牙生育协会的辅助生殖技术登记处，对 2002-2004 年的数据进行了分析。结果表明，分别有 74%、96%和 99%的体外受精/胞浆内单精子注射、卵母细胞捐赠和植入前遗传学诊断周期是在私立诊所进行的。公立诊所进行的三胚胎转移比例高于私立诊所（48.1%比 41.7%）。私立诊所进行了更多的选择性转移。每个周期开始、每次穿刺和每次转移的妊娠率在私立诊所中明显高于公立诊所（29.1%、32.7%和 35.9%比 25.2%、28.5%和 32.6%）（P<0.05）。两种类型的诊所的种植率都逐年上升，私立诊所的种植率明显更高（P<0.05）。私立诊所的多胎妊娠率也明显更高（30.8%比 26.4%）（P<0.05）。总之，公立和私立诊所在活动量、提供的服务范围、临床实践和取得的成果方面存在差异。
