Kissin Dmitry M, Kulkarni Aniket D, Mneimneh Allison, Warner Lee, Boulet Sheree L, Crawford Sara, Jamieson Denise J
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Fertil Steril. 2015 Apr;103(4):954-61. doi: 10.1016/j.fertnstert.2014.12.127. Epub 2015 Jan 27.
To evaluate assisted reproductive technology (ART) ET practices in the United States and assess the impact of these practices on multiple births, which pose health risks for both mothers and infants.
Retrospective cohort analysis using the National ART Surveillance System data.
US fertility centers reporting to the National ART Surveillance System.
PATIENT(S): Noncanceled ART cycles conducted in the United States in 2012.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Multiple birth (birth of two or more infants, at least one of whom was live-born).
RESULT(S): Of 134,381 ART transfer cycles performed in 2012, 51,262 resulted in live births, of which 13,563 (26.5%) were multiple births: 13,123 twin and 440 triplet and higher order births. Almost half (46.1%) of these multiple births resulted from the following four cycle types: two fresh blastocyst transfers among favorable or average prognosis patients less than 35 years (1,931 and 1,341 multiple births, respectively), two fresh blastocyst transfers among donor-oocyte recipients (1,532 multiple births), and two frozen/thawed ETs among patients less than 35 years (1,452 multiple births). More than half of triplet or higher order births resulted from the transfer of two embryos (52.5% of births among fresh autologous transfers, 67.2% of births among donor-oocyte recipient transfers, and 42.9% among frozen/thawed autologous transfers).
CONCLUSION(S): A substantial reduction of ART-related multiple (both twin and triplet or higher order) births in the United States could be achieved by single blastocyst transfers among favorable and average prognosis patients less than 35 years of age and donor-oocyte recipients.
评估美国辅助生殖技术（ART）胚胎移植操作情况，并评估这些操作对多胎妊娠的影响，多胎妊娠对母亲和婴儿均构成健康风险。
使用国家ART监测系统数据进行回顾性队列分析。
向国家ART监测系统报告的美国生育中心。
2012年在美国进行的非取消ART周期。
无。
多胎妊娠（分娩两个或更多婴儿，其中至少一个为活产）。
2012年进行的134,381次ART移植周期中，51,262次分娩活产婴儿，其中13,563例（26.5%）为多胎妊娠：13,123例双胎妊娠以及440例三胎及以上妊娠。这些多胎妊娠中近一半（46.1%）源于以下四种周期类型：35岁以下预后良好或中等的患者进行两次新鲜囊胚移植（分别有1,931例和1,341例多胎妊娠）、供卵受者进行两次新鲜囊胚移植（1,532例多胎妊娠）以及35岁以下患者进行两次冻融胚胎移植（1,452例多胎妊娠）。超过一半的三胎及以上妊娠是由于移植了两个胚胎（新鲜自体移植分娩的52.5%、供卵受者移植分娩的67.2%以及冻融自体移植分娩的42.9%）。
通过对35岁以下预后良好和中等的患者以及供卵受者进行单囊胚移植，美国ART相关的多胎妊娠（包括双胎和三胎及以上妊娠）可大幅减少。
