Department of Obstetrics and Gynecology, Rush University Medical Center, 1653 W. Congress Pkwy, Suite 218 Kellogg, Chicago, IL, 60612, USA.
Department of Obstetrics and Gynecology, Loyola University Medical Center, 2160 S. 1st Avenue, Building 103, Maywood, IL, 60153, USA.
J Assist Reprod Genet. 2020 Apr;37(4):953-962. doi: 10.1007/s10815-020-01728-3. Epub 2020 Mar 4.
To determine whether gestational carrier (GC) in vitro fertilization (IVF) cycles (commissioned cycles) for same-sex or single male intended parents have an increased incidence of adverse perinatal outcomes compared with spontaneous cycles in the same GCs.
GC singleton pregnancies were identified from a database of 895 commissioned cycles from a large fertility center. Of these, 78 commissioned cycles met inclusion and exclusion criteria and were compared with 71 spontaneous cycles by the same GCs. The primary outcome was the composite score for adverse perinatal outcomes. Secondary outcomes included mode of delivery, birthweight, and gestational age. Chi-square test of association and Mann-Whitney U tests were used to compare categorical and continuous variables between the cohorts, respectively. Logistic and linear regressions controlling for GC age were constructed to determine the influence of GC cycle type on adverse perinatal outcomes.
Commissioned cycles were significantly associated with adverse perinatal outcomes (25.6% vs. 9.9%; p = 0.02) and lower average gestational age (38.7 ± 1.5 vs. 39.4 ± 0.9; p < 0.001) compared with spontaneous cycles. Commissioned cycle increased the likelihood of adverse perinatal outcomes (OR 3.3; p = 0.03) and was a significant independent predictor of a lower average gestational age (β = 0.897; p < 0.001). There were no significant differences in the incidence of vaginal deliveries or cesarean sections between commissioned and spontaneous cycles.
Commissioned cycles confer a greater incidence of composite perinatal complications and were independently associated with a lower average gestational age when compared with spontaneous pregnancies carried by the same GC despite a confirmed healthy uterine environment, sperm samples, and donor oocytes.
确定代孕母亲（GC）体外受精（IVF）周期（委托周期）为同性或单身男性预期父母的围产期不良结局发生率是否高于同一 GC 的自然周期。
从一个大型生育中心的 895 个委托周期数据库中确定 GC 单胎妊娠。其中，78 个委托周期符合纳入和排除标准，并与同一 GC 的 71 个自然周期进行比较。主要结局是不良围产期结局的综合评分。次要结局包括分娩方式、出生体重和胎龄。使用卡方检验和 Mann-Whitney U 检验分别比较队列之间的分类和连续变量。构建逻辑回归和线性回归，控制 GC 年龄，以确定 GC 周期类型对不良围产期结局的影响。
委托周期与不良围产期结局（25.6% vs. 9.9%；p=0.02）和平均胎龄较低（38.7±1.5 vs. 39.4±0.9；p<0.001）显著相关。与自然周期相比，委托周期增加了不良围产期结局的可能性（OR 3.3；p=0.03），并且是平均胎龄较低的显著独立预测因素（β=0.897；p<0.001）。委托周期和自然周期之间的阴道分娩或剖宫产发生率无显著差异。
与自然妊娠相比，委托周期尽管子宫环境、精子样本和供卵者均健康，但委托周期会导致更高的复合围产期并发症发生率，并且与较低的平均胎龄独立相关。
