Abdollahi Mahbubeh, Omani Samani Reza, Hemat Mandana, Arabipoor Arezoo, Shabani Fatemeh, Eskandari Farzad, Salehi Masoud
Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
Int J Fertil Steril. 2017 Oct;11(3):191-196. doi: 10.22074/ijfs.2017.4718. Epub 2017 Aug 27.
Multiple pregnancies are an important complication of assisted reproductive technology (ART). The present study aims to indentify the risk factors for multiple pregnancies independent of the number of transferred embryos.
This retrospective study reviewed the medical records of patients who underwent intracytoplasmic sperm injection (ICSI) cycles in Royan Institute between October 2011 and January 2012. We entered 12 factors that affected the number of gestational sacs into the poisson regression (PR) model. Factors were obtained from two study populations-cycles with double embryo transfer (DET) and cycles that transferred three embryos (TET). We sought to determine the factors that influenced the number of gestational sacs. These factors were entered into multivariable logistic regression (MLR) to identify risk factors for multiple pregnancies.
A total of 1000 patients referred to Royan Institute for ART during the study period. We included 606 eligible patients in this study. PR analysis demonstrated that the quality of transferred embryos and woman's age had a significant effect on the number of observed sacs in patients who underwent ICSI with DET. There was no significant predictive variable for multiple pregnancies according to MLR analysis. Our findings demonstrated that both regression models (PR and MLR) had the same outputs. A significant relation existed between age and fertilization rate with multiple pregnancies in patients who underwent ICSI with TET.
Single embryo transfer (SET) should be considered with the remaining embryos cryopreserved to prevent multiple pregnancies in women younger than 35 years of age who undergo ICSI cycles with high fertilization rates and good or excellent quality embryos. However, further prospective studies are necessary to evaluate whether SET in women with these risk factors can significantly decrease multiple pregnancies and improve cycle outcomes.
多胎妊娠是辅助生殖技术（ART）的一种重要并发症。本研究旨在确定独立于移植胚胎数量之外的多胎妊娠风险因素。
这项回顾性研究回顾了2011年10月至2012年1月在罗扬研究所接受卵胞浆内单精子注射（ICSI）周期治疗的患者的病历。我们将12个影响妊娠囊数量的因素纳入泊松回归（PR）模型。这些因素来自两个研究人群——双胚胎移植（DET）周期和移植三个胚胎（TET）的周期。我们试图确定影响妊娠囊数量的因素。将这些因素纳入多变量逻辑回归（MLR）以确定多胎妊娠的风险因素。
在研究期间，共有1000名患者转诊至罗扬研究所接受ART治疗。我们在本研究中纳入了606名符合条件的患者。PR分析表明，在接受DET的ICSI患者中，移植胚胎的质量和女性年龄对观察到的囊数有显著影响。根据MLR分析，没有显著的多胎妊娠预测变量。我们的研究结果表明，两个回归模型（PR和MLR）具有相同的输出结果。在接受TET的ICSI患者中，年龄与受精率和多胎妊娠之间存在显著关系。
对于年龄小于35岁、接受ICSI周期且受精率高、胚胎质量良好或优秀的女性，应考虑单胚胎移植（SET）并冷冻剩余胚胎，以预防多胎妊娠。然而，需要进一步的前瞻性研究来评估具有这些风险因素的女性进行SET是否能显著降低多胎妊娠并改善周期结局。
