Center for Assisted Reproduction, Bedford, Texas.
Fertil Steril. 2014 Jul;102(1):27-31. doi: 10.1016/j.fertnstert.2014.04.048. Epub 2014 Jun 4.
Clinics performing assisted reproductive technology (ART) procedures have collected data via registry and publicly reported pregnancy outcomes for more than 25 years. During this time, the practice of ART has changed considerably with frozen embryo transfer (FET) procedures contributing an increasing proportion of live births. Cycles initiated with the intent of embryo banking for the purpose of fertility preservation have been excluded from these public reports, because pregnancy outcomes are not immediately available. An unintended consequence of the common sense handling of fertility preservation has been that cycles performed with intentional short-term cryopreservation of all embryos for other indications have also been excluded from the report. Over the last few years, cryopreservation with short-term delayed transfer increasingly has been performed for reasons other than fertility preservation. The pregnancy outcomes of these cycles are expected within a reasonable time frame and should be transparently reported. The Society for Assisted Reproductive Technology has collaborated with the Centers for Disease Control and Prevention to "recapture" these cycles for the public reports. This recapture is done by linking the FET cycles to the stimulation cycles from which the embryos were derived and by changing the labels of the outcome success metrics. Stimulations using ART, initiated for the purpose of transferring embryos within 1 year will be included in the report despite any prospective intent to freeze all eggs or embryos. A positive outcome will be reported when a live birth results from the first embryo transfer following stimulation ("primary transfer"). Linkage of ovarian stimulation and egg-retrieval procedures to FET will also allow development of other success metrics to further benefit fertility patients.
从事辅助生殖技术 (ART) 程序的诊所通过注册收集数据，并公开报告妊娠结果已经超过 25 年。在此期间，ART 的实践发生了很大变化，冷冻胚胎移植 (FET) 程序在活产中所占的比例越来越大。出于生育力保存目的而进行的胚胎冷冻保存的周期已被排除在这些公开报告之外，因为妊娠结果不能立即获得。生育力保存的常见处理方式带来了一个意想不到的后果，即出于其他指征而进行的有意图的短期所有胚胎冷冻保存的周期也被排除在报告之外。在过去几年中，出于除生育力保存以外的原因，短期延迟转移的冷冻保存越来越常见。这些周期的妊娠结果预计在合理的时间范围内，应透明地报告。辅助生殖技术协会与疾病控制与预防中心合作，“重新纳入”这些周期以进行公共报告。这是通过将 FET 周期与胚胎来源的刺激周期联系起来，并改变结果成功指标的标签来实现的。尽管有冷冻所有卵子或胚胎的前瞻性意图，但为在 1 年内转移胚胎而启动的使用 ART 的刺激将包括在报告中。刺激后首次胚胎转移（“原发性转移”）导致活产，将报告阳性结果。将卵巢刺激和取卵程序与 FET 联系起来，也将允许开发其他成功指标，以进一步使生育力患者受益。
