Perinatal and Reproductive Epidemiology Research Unit, School Women's and Children's Health, University of New South Wales, Level 2, McNevin Dickson Building, Randwick Hospitals Campus, Randwick NSW 2031, Australia.
Hum Reprod. 2010 Aug;25(8):1996-2005. doi: 10.1093/humrep/deq145. Epub 2010 Jun 2.
The practice of single embryo transfer (SET) is highly accepted by clinicians in Australia. This study investigates whether the SET of blastocysts results in optimal perinatal outcomes.
This retrospective population-based study included 34 035 single or double embryo transfer cycles in women who had their first fresh autologous treatment in Australia during 2004-2007. Pregnancy, live delivery and 'healthy baby' (live born term singleton of > or = 2500 g birthweight and survived for at least 28 days without a notified/reported congenital anomaly) rates per transfer cycle were compared in four groups: selective single embryo transfer (SSET), unselective single embryo transfer (USSET), selective double embryo transfer (SDET) and unselective double embryo transfer (USDET). Live delivery and 'healthy baby' rates per transfer following SSET were further compared by number of embryos available. The analysis was stratified by woman's age and stage of embryo development.
The highest rates of live delivery and 'healthy baby' per transfer cycle (46.2 and 38.0%) were achieved with transfer of a single blastocyst in women aged younger than 35 years. In women aged younger than 40 years, SSET had a significantly higher rate of 'healthy baby' per transfer cycle than did SDET regardless of stage of embryo development. In woman aged younger than 35 years who had SSET, there was no significant difference in live delivery and 'healthy baby' rates per transfer cycle whether two, three, four or five embryos were available. For all of these women, SSET of a cleavage embryo had significantly lower rates of live delivery and 'healthy baby' per transfer cycle compared with SSET of a blastocyst where only two blastocysts were available.
Consultation with the patient with respect to the advantage of extended culture and selective single blastocyst transfer will result in better success rates following assisted reproductive technology treatment in Australia.
在澳大利亚，临床医生高度接受单胚胎移植（SET）实践。本研究调查了囊胚的 SET 是否会带来最佳的围产期结局。
本回顾性基于人群的研究纳入了 2004 年至 2007 年期间在澳大利亚首次接受新鲜自体治疗的女性的 34035 个单胚胎或双胚胎移植周期。在四个组中比较了每个移植周期的妊娠率、活产率和“健康婴儿”率（活产足月单胎体重≥2500g 且至少存活 28 天，无通知/报告先天性异常）：选择性单胚胎移植（SSET）、非选择性单胚胎移植（USSET）、选择性双胚胎移植（SDET）和非选择性双胚胎移植（USDET）。进一步按胚胎数量比较了 SSET 后每个移植的活产率和“健康婴儿”率。分析按女性年龄和胚胎发育阶段分层。
在年龄小于 35 岁的女性中，移植单个囊胚的每个移植周期的活产率和“健康婴儿”率最高（分别为 46.2%和 38.0%）。在年龄小于 40 岁的女性中，无论胚胎发育阶段如何，SSET 的每个移植周期“健康婴儿”率均显著高于 SDET。在年龄小于 35 岁且接受 SSET 的女性中，无论有两个、三个、四个还是五个胚胎，每个移植周期的活产率和“健康婴儿”率均无显著差异。对于所有这些女性，与仅可用两个囊胚的情况下相比，SSET 培养时间延长和选择性单囊胚移植的优势咨询将导致澳大利亚辅助生殖技术治疗的成功率更高。
与患者就延长培养和选择性单囊胚移植的优势进行咨询将使澳大利亚的辅助生殖技术治疗获得更好的成功率。
