Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Centre, PO-Box 9101, 6500 HB Nijmegen, The Netherlands.
Hum Reprod. 2010 Jul;25(7):1782-6. doi: 10.1093/humrep/deq080. Epub 2010 May 19.
We assessed all deaths in the Netherlands that might have been related to IVF or to an IVF pregnancy in order to investigate this most serious complication.
All deaths related to IVF, within 1 year after IVF, from 1984 to 2008 were collected by sending a letter to all gynaecologists, and by retrieving data from a large cohort study examining the late effects of ovarian stimulation (OMEGA) and from the Dutch Maternal Mortality Committee.
Six deaths were directly related to IVF (6/100,000), 17 deaths were directly related to the IVF pregnancy (42.5/100,000) and eight deaths were neither related to the IVF nor to the IVF-related pregnancy. The overall mortality in patients undergoing IVF procedures was lower than in the general population, whereas the overall mortality related to IVF pregnancies was higher than the maternal mortality in the general population.
The decreased mortality is probably the result of a 'healthy female effect' in women undergoing IVF. The high maternal mortality in IVF pregnancies is probably related to the high number of multiple pregnancies and to the fact that (donor egg) IVF is successfully used in women who are older. The fact that only a few deaths directly related to IVF are reported in the literature whereas we observed six in the Netherlands indicates worldwide under-reporting of IVF-related mortality. We underline the importance of reporting all lethal cases to the European Society of Human Reproduction and Embryology Committee 'Safety and Quality after IVF'.
为了调查这一最严重的并发症，我们评估了荷兰所有可能与试管婴儿或试管婴儿妊娠有关的死亡病例。
通过向所有妇科医生发送一封信，并从一项大型队列研究（评估卵巢刺激的晚期影响[OMEGA]）和荷兰孕产妇死亡率委员会中检索数据，收集了 1984 年至 2008 年在试管婴儿治疗后 1 年内与试管婴儿相关的所有死亡病例。
6 例死亡与试管婴儿直接相关（6/100000），17 例死亡与试管婴儿妊娠直接相关（42.5/100000），8 例死亡与试管婴儿和试管婴儿相关妊娠均无直接关系。接受试管婴儿手术的患者的总体死亡率低于普通人群，而与试管婴儿妊娠相关的总体死亡率高于普通人群的孕产妇死亡率。
死亡率降低可能是接受试管婴儿治疗的女性中存在“健康女性效应”的结果。试管婴儿妊娠中较高的孕产妇死亡率可能与多胎妊娠的数量较多以及（供卵）试管婴儿成功用于年龄较大的妇女有关。文献中仅报告了少数几例与试管婴儿直接相关的死亡病例，而我们在荷兰观察到了 6 例，这表明全球对试管婴儿相关死亡率的报告不足。我们强调向欧洲人类生殖与胚胎学会委员会“试管婴儿后的安全性和质量”报告所有致命病例的重要性。
