Albert Einstein College of Medicine, Department of Obstetrics/Gynecology and Women's Health, Bronx, New York; Montefiore's Institute for Reproductive Medicine and Health, Hartsdale, New York.
Albert Einstein College of Medicine, Department of Obstetrics/Gynecology and Women's Health, Bronx, New York.
Fertil Steril. 2018 Jan;109(1):118-122. doi: 10.1016/j.fertnstert.2017.10.003.
To study the incidence and risk factors of multiple pregnancies after elective single ET.
Historic cohort.
Not applicable.
PATIENT(S): Women <35 years of age undergoing elective single ET entered in the SART CORS database from 2010 to 2013.
Not applicable.
MAIN OUTCOME MEASURE(S): Rate of sex discordant pregnancies. Rate of same sex pregnancies and risk factors for both same sex and sex discordant pregnancies.
RESULT(S): A total of 32,600 cycles were reported to SART CORS during this time period. There were 15,143 pregnancies from which 14,888 were singletons (98.3%), 23 sex discordant (0.15%) multiple pregnancies, 226 (1.5%) sex concordant multiple pregnancies, and 6 (0.01%) pregnancies without sex information. When Weinberg's differential rule was applied, the rate of dizygotic pregnancies was calculated to be 18%. Unexplained infertility was found to be the biggest risk factor for sex discordant multiple pregnancies (adjusted odds ratio 4.33, 95% confidence interval 1.4-13.1), followed by elevated body mass index (BMI). The only risk factor found for sex concordant pregnancies was undergoing a fresh transfer (adjusted odds ratio 1.4, 95% confidence interval 1.02-1.95).
CONCLUSION(S): Elective single ET improves, but does not completely eliminate the risk of multiple pregnancies. Patients should be counseled that there might be up to a ∼2% risk of multiple pregnancies, of which up to 18% can be dizygotic. Patients with elevated BMI and unexplained fertility may be at higher risk for sex discordant multiple pregnancies and patients undergoing fresh cycles may be at higher risk for sex concordant multiple pregnancies.
研究选择性单胚胎移植后多胎妊娠的发生率和相关风险因素。
历史性队列研究。
不适用。
年龄<35 岁的患者，于 2010 年至 2013 年在 SART CORS 数据库中接受选择性单胚胎移植。
不适用。
性别的不同的妊娠率、同性别的妊娠率及同性别的和性别的不同的妊娠的风险因素。
在此期间，共向 SART CORS 报告了 32600 个周期。有 15143 例妊娠，其中 14888 例是单胎（98.3%），23 例是性别的不同的多胎妊娠（0.15%），226 例是同性别的多胎妊娠（1.5%），6 例（0.01%）妊娠无性别信息。当应用 Weinberg 的差异法则时，估计双胎妊娠的发生率为 18%。未解释的不孕被认为是性别的不同的多胎妊娠的最大风险因素（调整后的优势比 4.33，95%置信区间 1.4-13.1），其次是体重指数（BMI）升高。唯一发现的同性别的妊娠的风险因素是进行新鲜胚胎移植（调整后的优势比 1.4，95%置信区间 1.02-1.95）。
选择性单胚胎移植提高了，但不能完全消除多胎妊娠的风险。应告知患者，多胎妊娠的风险可能高达 2%，其中多达 18%可能是双胎妊娠。BMI 升高和未解释的不孕的患者可能有更高的性别的不同的多胎妊娠的风险，而进行新鲜周期的患者可能有更高的同性别的多胎妊娠的风险。
