Juntendo University Faculty of Medicine, Department of Obstetrics and Gynecology, Tokyo 113-8421, Japan; Oita University, Faculty of Medicine, Department of Obstetrics and Gynecology, Oita 879-5593, Japan.
Juntendo University Faculty of Medicine, Department of Obstetrics and Gynecology, Tokyo 113-8421, Japan.
Reprod Biomed Online. 2020 Mar;40(3):374-380. doi: 10.1016/j.rbmo.2019.11.008. Epub 2019 Nov 29.
What is the prevalence of triplet and quadruplet pregnancies after single embryo transfer (SET) in Japan.
A retrospective observational study was conducted on 274,605 pregnancies after 937,848 SET cycles in registered assisted reproductive technology (ART) data from the Japanese ART national registry database between 2007 and 2014. A questionnaire survey of ART centres was also conducted. Data on pregnancies with embryo division into three or more after SET were analysed.
According to the Japanese ART national registry database, SET resulted in 109 triplet pregnancies (0.04% of pregnancies), and the questionnaire reports from 31 centres revealed 33 triplet and one quadruplet pregnancies. After exclusion of 20 duplicated cases, 122 triplet and one quadruplet pregnancies included 46 monochorionic (one gestational sac [37.4%]), 18 dichorionic (two gestational sacs [14.6%]) and 59 trichorionic pregnancies (three gestational sacs [48.0%]). Compared with singleton pregnancies, patients with monozygotic triplet or quadruplet pregnancies were less frequently diagnosed with unexplained infertility (P = 0.004), more often received gonadotrophin injections for ovarian stimulation in 39 cases with information available (P = 0.021) and underwent more blastocyst transfers and assisted hatching (P = 0.002 and P < 0.001, respectively). The proportion of live birth, defined as at least one baby born, excluding induced abortion, was 64.6% (73/116 pregnancies) of monozygotic triplet or quadruplet pregnancies.
Combined Japanese ART national registry and survey data revealed 122 triplet and one quadruplet pregnancies, the majority after cryopreserved embryo transfer. Most were conceived after blastocyst transfer and often after assisted hatching, which are potential risk factors for zygotic splitting.
在日本，单胚胎移植（SET）后三胞胎和四胞胎妊娠的发生率是多少。
对 2007 年至 2014 年间日本辅助生殖技术（ART）国家注册数据库中 937848 个 SET 周期后的 274605 例妊娠进行了回顾性观察研究。还对 ART 中心进行了问卷调查。分析了 SET 后胚胎分裂成三个或更多的妊娠数据。
根据日本 ART 国家注册数据库，SET 导致 109 例三胞胎妊娠（妊娠的 0.04%），31 个中心的问卷调查报告显示 33 例三胞胎和 1 例四胞胎妊娠。排除 20 例重复病例后，122 例三胞胎和 1 例四胞胎妊娠包括 46 例单绒毛膜（一个羊膜囊[37.4%]）、18 例双绒毛膜（两个羊膜囊[14.6%]）和 59 例三绒毛膜妊娠（三个羊膜囊[48.0%]）。与单胎妊娠相比，单卵三胞胎或四胞胎妊娠患者不明原因不孕的诊断频率较低（P=0.004），在有信息可查的 39 例中，更常接受促性腺激素注射进行卵巢刺激（P=0.021），并且进行了更多的囊胚移植和辅助孵化（P=0.002 和 P<0.001）。活产的定义为至少有一个婴儿出生，不包括人工流产，单卵三胞胎或四胞胎妊娠的活产率为 64.6%（73/116 例妊娠）。
结合日本 ART 国家注册和调查数据，共发现 122 例三胞胎和 1 例四胞胎妊娠，大多数是在冷冻胚胎移植后妊娠。大多数是在囊胚移植后妊娠，且经常在辅助孵化后妊娠，这可能是合子分裂的潜在危险因素。
