Department of Obstetrics and Gynecology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
Fertil Steril. 2011 Dec;96(6):1367-9. doi: 10.1016/j.fertnstert.2011.09.007. Epub 2011 Sep 29.
To report the outcomes of a program policy instituted in 2004 mandating single-embryo transfer (mSET) for all women aged <38 years, with at least seven zygotes, no prior failed fresh cycle at our center, and at least one good-quality blastocyst.
Retrospective cohort study.
Academic medical center.
PATIENT(S): All women <38 years old undergoing a fresh cycle with autologous oocytes and all women undergoing a fresh cycle with donor oocytes from June 1, 1999, to May 31, 2004 (before mSET) and from June 1, 2004, to May 31, 2009 (after mSET).
INTERVENTION(S): mSET policy implementation.
MAIN OUTCOME MEASURE(S): Live-birth rate, multiple pregnancy rate, clinical volume, and outcomes of all mSET fresh IVF transfers were analyzed.
RESULT(S): Clinical volume was unchanged between the two time groups. After implementation of mSET, live-birth rates improved from 51.1% to 55.9% and multiple-birth rates dropped from 34.8% to 17.5%. A total of 364 mSET fresh transfers were performed with a live-birth rate of 64.6% and a multiple-birth rate of 3.4%.
CONCLUSION(S): A mandatory SET policy based on prognostic factors can be instituted with no drop in clinical volume and no negative effect on delivery rates. Multiple gestation rates can be dramatically lowered.
报告一项于 2004 年实施的政策方案的结果，该方案要求所有年龄<38 岁、至少有 7 个受精卵、在本中心之前的新鲜周期未失败且至少有一个优质囊胚的女性进行单胚胎移植（mSET）。
回顾性队列研究。
学术医疗中心。
所有年龄<38 岁的接受自体卵母细胞新鲜周期的女性和所有年龄<38 岁的接受供体卵母细胞新鲜周期的女性，周期时间分别为 1999 年 6 月 1 日至 2004 年 5 月 31 日（mSET 前）和 2004 年 6 月 1 日至 2009 年 5 月 31 日（mSET 后）。
mSET 政策的实施。
活产率、多胎妊娠率、临床量和所有 mSET 新鲜 IVF 转移的结果。
两个时间组的临床量没有变化。实施 mSET 后，活产率从 51.1%提高到 55.9%，多胎妊娠率从 34.8%降至 17.5%。共进行了 364 次 mSET 新鲜移植，活产率为 64.6%，多胎妊娠率为 3.4%。
可以实施基于预测因素的强制性 SET 政策，而不会降低临床量，也不会对分娩率产生负面影响。多胎妊娠率可显著降低。
