Bhattacharya Siladitya, Kamath Mohan S
Division of Applied Health Sciences, University of Aberdeen, Obstetrics and Gynaecology, Aberdeen Maternity Hospital, Foresterhill, Aberdeen AB25 2ZD, UK.
Reproductive Medicine Unit, Christian Medical College, Vellore, India.
Best Pract Res Clin Obstet Gynaecol. 2014 Feb;28(2):191-9. doi: 10.1016/j.bpobgyn.2013.11.005. Epub 2013 Dec 4.
Multiple pregnancy, a complication of assisted reproduction technology, is associated with poorer maternal and perinatal outcomes. The primary reason behind this is the strategy of replacing more than one embryo during an assisted reproduction technology cycle to maximise pregnancy rates. The solution to this problem is to reduce the number of embryos transferred during in-vitro fertilisation. The transition from triple- to double-embryo transfer, which decreased the risk of triplets without compromising pregnancy rates, was easily implemented. The adoption of a single embryo transfer policy has been slow because of concerns about impaired pregnancy rates in a fresh assisted reproduction technology cycle. Widespread availability of effective cryopreservation programmes means that elective single embryo transfer, along with subsequent frozen embryo transfers, could provide a way forward. Any such strategy will need to consider couples' preferences and existing funding policies, both of which have a profound influence on decision making around embryo transfer.
多胎妊娠是辅助生殖技术的一种并发症，与较差的孕产妇和围产期结局相关。其背后的主要原因是在辅助生殖技术周期中为了最大化妊娠率而移植多个胚胎的策略。解决这个问题的办法是减少体外受精过程中移植的胚胎数量。从移植三个胚胎到移植两个胚胎的转变很容易实施，这降低了三胎妊娠的风险，同时又不影响妊娠率。由于担心在新鲜的辅助生殖技术周期中妊娠率受损，单胚胎移植政策的采用一直很缓慢。有效的冷冻保存方案的广泛应用意味着选择性单胚胎移植以及随后的冻融胚胎移植可能提供一条前进的道路。任何这样的策略都需要考虑夫妻双方的偏好和现有的资助政策，这两者对围绕胚胎移植的决策都有深远影响。
