Clua Elisabet, Tur Rosa, Coroleu Buenaventura, Rodríguez Ignacio, Boada Montserrat, Gómez M José, Barri Pedro Nolasc, Veiga Anna
Reproductive Medicine Service, Departament of Obstetrics, Gynaecology and Reproduction, Hospital Universitari Quiron Dexeus, Barcelona, Spain.
Reproductive Medicine Service, Departament of Obstetrics, Gynaecology and Reproduction, Hospital Universitari Quiron Dexeus, Barcelona, Spain.
Reprod Biomed Online. 2015 Aug;31(2):154-61. doi: 10.1016/j.rbmo.2015.04.013. Epub 2015 May 11.
Multiple pregnancies involve high obstetric and perinatal risks. The aim of this study is to evaluate, in a pilot randomized control study, if the cumulative pregnancy and live birth rates of elective single embryo transfer (eSET) are comparable to the ones obtained with elective double embryo transfer (eDET). A total of 65 patients with at least two good quality embryos was randomized, 34 (52.3%) assigned to the eSET group and 31 (47.7%) to the eDET group. The cumulative pregnancy rates (eSET: 73.5% and eDET: 77.4%. RR: 0.95 95% CI: 0.72-1.25) and live birth rates (eSET: 58.8% and eDET: 61.3%. RR: 0.96 95% CI: 0.64-1.42) were similar in the two groups. The twin pregnancy rate in the fresh transfers of eDET group was 47.7% and 0% in the eSET group. The medical team decided to interrupt the study for reasons related to risks associated with elevated twin pregnancy rate, leaving low numbers of patients within the study as a result. When considering cumulative success rates, eSET and eDET are similar in terms of efficacy. However, eDET involves an increased and unacceptable twin pregnancy rate. The only prevention strategy is single embryo transfer.
多胎妊娠存在较高的产科和围产期风险。本研究的目的是在一项初步随机对照研究中评估选择性单胚胎移植（eSET）的累积妊娠率和活产率是否与选择性双胚胎移植（eDET）的相当。共有65例至少有两个优质胚胎的患者被随机分组，34例（52.3%）被分配到eSET组，31例（47.7%）被分配到eDET组。两组的累积妊娠率（eSET：73.5%，eDET：77.4%。相对风险（RR）：0.95，95%置信区间（CI）：0.72 - 1.25）和活产率（eSET：58.8%，eDET：61.3%。RR：0.96，95% CI：0.64 - 1.42）相似。eDET组新鲜移植中的双胎妊娠率为47.7%，eSET组为0%。由于双胎妊娠率升高相关的风险，医疗团队决定中断研究，结果导致研究中的患者数量减少。在考虑累积成功率时，eSET和eDET在疗效方面相似。然而，eDET会导致不可接受的双胎妊娠率增加。唯一的预防策略是单胚胎移植。
