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6623 例经微刺激和玻璃化 vs 新鲜单胚胎移植后出生的单胎新生儿结局和出生缺陷。

Neonatal outcome and birth defects in 6623 singletons born following minimal ovarian stimulation and vitrified versus fresh single embryo transfer.

机构信息

Kato Ladies Clinic, Tokyo, Japan.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2012 Mar;161(1):46-50. doi: 10.1016/j.ejogrb.2011.12.005. Epub 2011 Dec 24.

Abstract

OBJECTIVE

To compare neonatal outcome between children born after vitrified versus fresh single-embryo transfer (SET).

STUDY DESIGN

Retrospective, single-centre cohort study of 6623 delivered singletons following 29,944 single-embryo transfers. Patients underwent minimal ovarian stimulation/natural cycle IVF followed by SET of fresh or vitrified-warmed (using Cryotop, Kitazato) cleavage-stage embryos or blastocysts. Outcome measures were gestational age at delivery, birth weight, birth length, low birth weight (LBW), small for gestational age (SGA) and large for gestational age (LGA) infants, perinatal mortality and minor/major birth defects (evaluated by parent questionnaire).

RESULTS

Gestational age (38.6 ± 2 versus 38.7 ± 1.9 weeks) and preterm delivery rate (6.9% versus 6.9%, aOR: 0.96 95%CI: 0.76-1.22) in singletons born after the transfer of vitrified embryos were comparable to those born after the transfer of fresh embryos. Children born after the transfer of vitrified embryos had a higher birth weight (3028 ± 465 versus 2943 ± 470 g, p<0.0001) and lower LBW (8.5% versus 11.9%, aOR: 0.65 95%CI: 0.53-0.79) and SGA (3.6% versus 7.6% aOR: 0.43 95%CI: 0.33-0.56) rates. Total birth defect rates (including minor anomalies) (2.4% versus 1.9%, aOR: 1.41 95%CI: 0.96-2.10) and perinatal mortality rates (0.6% versus 0.5%, aOR: 1.02 95%CI: 0.21-4.85) were comparable between the vitrified and fresh groups.

CONCLUSIONS

Vitrification of embryos/blastocysts did not increase the incidence of adverse neonatal outcomes or birth defects following single embryo transfer.

摘要

目的

比较玻璃化与新鲜单胚胎移植(SET)后新生儿结局。

研究设计

对 29944 个单胚胎移植后分娩的 6623 例单胎进行回顾性、单中心队列研究。患者行微刺激/自然周期 IVF,行新鲜或玻璃化冷冻-解冻(使用 Cryotop,Kitazato)卵裂期胚胎或囊胚 SET。结局指标为分娩时的胎龄、出生体重、出生身长、低体重儿(LBW)、小于胎龄儿(SGA)和大于胎龄儿(LGA)、围产儿死亡率和轻微/严重出生缺陷(通过家长问卷评估)。

结果

玻璃化胚胎移植后单胎的胎龄(38.6 ± 2 周与 38.7 ± 1.9 周)和早产率(6.9%与 6.9%,aOR:0.96,95%CI:0.76-1.22)与新鲜胚胎移植后相似。玻璃化胚胎移植后出生的儿童出生体重更高(3028 ± 465 克与 2943 ± 470 克,p<0.0001),LBW(8.5%与 11.9%,aOR:0.65,95%CI:0.53-0.79)和 SGA(3.6%与 7.6%,aOR:0.43,95%CI:0.33-0.56)发生率更低。总出生缺陷率(包括轻微异常)(2.4%与 1.9%,aOR:1.41,95%CI:0.96-2.10)和围产儿死亡率(0.6%与 0.5%,aOR:1.02,95%CI:0.21-4.85)在玻璃化组和新鲜组之间无差异。

结论

胚胎/囊胚玻璃化冷冻后行单胚胎移植不会增加新生儿不良结局或出生缺陷的发生率。

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