Wang Alex Y, Dill Sandra K, Bowman Mark, Sullivan Elizabeth A
Faculty of Health, University of Technology Sydney, Broadway, New South Wales, Australia.
Access Australia, Silverwater, New South Wales, Australia.
Aust N Z J Obstet Gynaecol. 2016 Jun;56(3):255-9. doi: 10.1111/ajo.12451. Epub 2016 Feb 25.
Information on gestational surrogacy arrangement and outcomes is limited in Australia.
This national population study investigates the epidemiology of gestational surrogacy arrangement in Australia: treatment procedures, pregnancy and birth outcomes.
A retrospective study was conducted of 169 intended parents cycles and 388 gestational carrier cycles in Australia in 2004-2011. Demographics were compared between intended parents and gestational carrier cycles. Pregnancy and birth outcomes were compared by number of embryos transferred.
Over half (54%) intended parents cycles were in women aged <35 years compared to 38% of gestational carrier cycles. About 77% of intended parents cycles were of nulliparous women compared to 29% of gestational carrier cycles. Of the 360 embryo transfer cycles, 91% had cryopreserved embryos transferred and 69% were single-embryo transfer (SET) cycles. The rates of clinical pregnancy and live delivery were 26% and 19%, respectively. There were no differences in rates of clinical pregnancy and live delivery between SET cycles (27% and 19%) and double-embryo transfer (DET) cycles (25% and 19%). Five of 22 deliveries following DET were twin deliveries compared to none of 48 deliveries following SET. There were 73 liveborn babies following gestational surrogacy treatment, including 9 liveborn twins. Of these, 22% (16) were preterm and 14% (10) were low birthweight. Preterm birth was 13% for liveborn babies following SET, lower than the 31% or liveborn babies following DET.
To avoid adverse outcomes for both carriers and babies, SET should be advocated in all gestational surrogacy arrangements.
在澳大利亚，关于妊娠代孕安排及结果的信息有限。
这项全国性人群研究调查了澳大利亚妊娠代孕安排的流行病学情况：治疗程序、妊娠及分娩结局。
对2004年至2011年澳大利亚169例意向父母周期和388例妊娠载体周期进行回顾性研究。比较了意向父母周期和妊娠载体周期的人口统计学特征。按移植胚胎数量比较妊娠及分娩结局。
超过半数（54%）的意向父母周期是年龄小于35岁的女性，而妊娠载体周期中这一比例为38%。约77%的意向父母周期是未生育过的女性，而妊娠载体周期中这一比例为29%。在360个胚胎移植周期中，91%移植了冷冻胚胎，69%是单胚胎移植（SET）周期。临床妊娠率和活产率分别为26%和19%。SET周期（27%和19%）和双胚胎移植（DET）周期（25%和19%）的临床妊娠率和活产率没有差异。DET后22例分娩中有5例是双胞胎分娩，而SET后48例分娩中无一例是双胞胎分娩。妊娠代孕治疗后有73例活产婴儿，包括9例活产双胞胎。其中，22%（16例）为早产，14%（10例）为低出生体重。SET后活产婴儿的早产率为13%，低于DET后活产婴儿的31%。
为避免对载体和婴儿产生不良后果，在所有妊娠代孕安排中都应提倡单胚胎移植。
