Harbottle Stephen, Hughes Ciara, Cutting Rachel, Roberts Steve, Brison Daniel
a Cambridge IVF, Cambridge University Hospitals NHS Trust, Kefford House , Maris Lane Cambridge , UK.
b HARI Clinic, Rotunda Hospital , Dublin , Eire.
Hum Fertil (Camb). 2015 Sep;18(3):165-83. doi: 10.3109/14647273.2015.1083144.
A significant number of multiple pregnancies and births worldwide continue to occur following treatment with Assisted Reproductive Technologies (ARTs). Whilst efforts have been made to increase the proportion of elective single embryo transfer (eSET) cycles, the multiple pregnancy rate or MPR remains at a level that most consider unacceptable given the associated clinical risks to mothers and babies, and the additional costs associated with neonatal care of premature and low birth weight babies. Northern Europe, Australia and Japan have continued to lead the way in the adoption of eSET. Randomised controlled trials or RCTs, meta-analyses and economic analyses support the implementation of an eSET policy, particularly in light of recent advances in ARTs. This paper provides a review of current evidence and an update to the eSET guidelines first published by Cutting et al. (2008) intended to assist ART clinics in the implementation of an effective eSET policy.
全球范围内,相当数量的多胎妊娠和分娩仍在辅助生殖技术(ART)治疗后出现。尽管已努力提高选择性单胚胎移植(eSET)周期的比例,但多胎妊娠率(MPR)仍处于大多数人认为不可接受的水平,因为这会给母婴带来相关临床风险,以及与早产和低体重儿新生儿护理相关的额外成本。北欧、澳大利亚和日本在采用eSET方面继续处于领先地位。随机对照试验(RCT)、荟萃分析和经济分析支持实施eSET政策,特别是鉴于ART的最新进展。本文对当前证据进行了综述,并更新了Cutting等人(2008年)首次发布的eSET指南,旨在协助ART诊所实施有效的eSET政策。