Devine Kate, Connell Matthew T, Richter Kevin S, Ramirez Christina I, Levens Eric D, DeCherney Alan H, Stillman Robert J, Widra Eric A
Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland; Shady Grove Fertility Reproductive Science Center, Washington, District of Columbia; Shady Grove Fertility Reproductive Science Center, Rockville, Maryland.
Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland.
Fertil Steril. 2015 Jun;103(6):1454-60.e1. doi: 10.1016/j.fertnstert.2015.02.032. Epub 2015 Mar 23.
To compare live-birth rates, blastocyst to live-birth efficiency, gestational age, and birth weights in a large cohort of patients undergoing single versus double thawed blastocyst transfer.
Retrospective cohort study.
Assisted reproduction technology (ART) practice.
PATIENT(S): All autologous frozen blastocyst transfers (FBT) of one or two vitrified-warmed blastocysts from January 2009 through April 2012.
INTERVENTION(S): Single or double FBT.
MAIN OUTCOME MEASURE(S): Live birth, blastocyst to live-birth efficiency, preterm birth, low birth weight.
RESULT(S): Only supernumerary blastocysts with good morphology (grade BB or better) were vitrified, and 1,696 FBTs were analyzed. No differences were observed in patient age, rate of embryo progression, or postthaw blastomere survival. Double FBT yielded a higher live birth per transfer, but 33% of births from double FBT were twins versus only 0.6% of single FBT. Double FBT was associated with statistically significant increases in preterm birth and low birth weight, the latter of which was statistically significant even when the analysis was limited to singletons. Of the blastocysts transferred via single FBT, 38% resulted in a liveborn child versus only 34% with double FBT. This suggests that two single FBTs would result in more liveborn children with significantly fewer preterm births when compared with double FBT.
CONCLUSION(S): Single FBT greatly decreased multiple and preterm birth risk while providing excellent live-birth rates. Patients should be counseled that a greater overall number of live born children per couple can be expected when thawed blastocysts are transferred one at a time.
比较接受单次与双次解冻囊胚移植的大量患者的活产率、囊胚至活产效率、孕周和出生体重。
回顾性队列研究。
辅助生殖技术（ART）机构。
2009年1月至2012年4月期间进行一或两个玻璃化-复温囊胚的所有自体冷冻囊胚移植（FBT）。
单次或双次FBT。
活产、囊胚至活产效率、早产、低出生体重。
仅对形态良好（BB级或更佳）的多余囊胚进行玻璃化处理，共分析了1696例FBT。患者年龄、胚胎发育率或解冻后卵裂球存活率无差异。双次FBT每次移植的活产率更高，但双次FBT出生的婴儿中有33%为双胞胎，而单次FBT仅为0.6%。双次FBT与早产和低出生体重的统计学显著增加相关，即使分析仅限于单胎，后者也具有统计学显著性。通过单次FBT移植的囊胚中，38%产下活产儿，而双次FBT仅为34%。这表明，与双次FBT相比，两次单次FBT将产生更多活产儿，早产显著减少。
单次FBT在提供优异活产率的同时，大大降低了多胎和早产风险。应告知患者，解冻囊胚一次移植一个时，每对夫妇有望获得更多的活产儿总数。
