OVO Fertility, Montréal, Québec, Canada.
Reprod Biomed Online. 2011 Oct;23(4):500-4. doi: 10.1016/j.rbmo.2011.05.020. Epub 2011 Jul 1.
In August 2010, the provincial government of Québec, Canada introduced funding of assisted reproduction treatment through the provincial health programme. Alongside this benefit, legislation was introduced to control assisted reproduction treatment activities in the province, including restrictions on the number of embryos that could be transferred in any one cycle. The aim of the programme was to transfer a single embryo in every cycle; multiple embryos could be transferred under suboptimal conditions but required physician justification. In the first 3 months of this programme, 1353 cycles of IVF were performed in five Québec assisted reproduction centres, with an overall clinical pregnancy rate of 32% per embryo transfer and 50% of transfers used elective single-embryo transfer (eSET). The multiple-pregnancy rate was only 3.7% per clinical pregnancy. In 2009, prior to the introduction of the programme, eSET was used in only 1.6% of embryo transfers, resulting in a multiple-pregnancy rate of 25.6%. These data demonstrate that providing provincially funded assisted reproduction treatment created an environment in which the aggressive use of eSET was not only possible, but also rapidly implemented. The result was a dramatic drop in multiple-pregnancy rates, approaching those for natural pregnancies.
2010 年 8 月，加拿大魁北克省政府通过省级卫生计划为辅助生殖治疗提供资金。除了这项福利，该省还出台了立法来控制辅助生殖治疗活动，包括限制每个周期可转移的胚胎数量。该计划的目的是在每个周期中转移一个单一的胚胎；在条件不佳的情况下可以转移多个胚胎，但需要医生的证明。在该计划实施的头 3 个月里，魁北克的五个辅助生殖中心共进行了 1353 个体外受精周期，每个胚胎转移的临床妊娠率总体为 32%，50%的转移采用了选择性单胚胎转移（eSET）。多胎妊娠率仅为每例临床妊娠 3.7%。在该计划实施之前的 2009 年，eSET 仅用于 1.6%的胚胎转移，导致多胎妊娠率为 25.6%。这些数据表明，提供省级资助的辅助生殖治疗创造了一个环境，使得积极使用 eSET 不仅成为可能，而且迅速得到实施。其结果是多胎妊娠率急剧下降，接近自然妊娠的水平。
