Frydman R, Forman R G, Belaisch-Allart J, Hazout A, Testart J
Unité Institut National de la Santé et de la Recherche Médicale (INSERM) 187, Hôpital Antoine Béclère, Clamart, France.
Fertil Steril. 1988 Sep;50(3):466-70. doi: 10.1016/s0015-0282(16)60134-6.
Conventionally, in in vitro fertilization (IVF) programs, all embryos obtained up to three are freshly transferred in the IVF cycle and supernumerary embryos frozen if cryopreservation facilities exist. This study was concerned with assessing alternative policies for embryo transfer (ET). When three or fewer embryos were obtained in the IVF cycle, fresh embryo transfer was either excluded (group I, n = 69) or only one embryo was immediately transferred (group II, n = 46), the remainder being transferred after freezing and thawing. The pregnancy rate in these two policies was compared to that in a control group of patients (group III, n = 115) in whom all the embryos were transferred in the IVF cycle. The ongoing pregnancy rate was similar in all three groups. No multiple pregnancies occurred in groups I and II compared with one in the controls. The consequences of these policies for pregnancy rates and the incidence of multiple gestation are discussed. It is concluded that the deliberate limitation of fresh ET to a maximum of one embryo followed by one or more cycles of thawed frozen ET is not detrimental to the pregnancy rate and is less likely to be associated with multiple gestations. Conversely, this policy increases the workload of the laboratory staff and raises certain ethical questions.
按照惯例，在体外受精（IVF）程序中，在IVF周期中获得的所有胚胎，最多三个会在该周期内新鲜移植，如果有冷冻保存设施，多余的胚胎则会被冷冻。本研究关注的是评估胚胎移植（ET）的替代策略。当在IVF周期中获得三个或更少胚胎时，新鲜胚胎移植要么被排除（第一组，n = 69），要么仅立即移植一个胚胎（第二组，n = 46），其余胚胎在冷冻和解冻后移植。将这两种策略的妊娠率与对照组患者（第三组，n = 115）的妊娠率进行比较，对照组患者的所有胚胎均在IVF周期内移植。三组的持续妊娠率相似。与对照组发生一例多胎妊娠相比，第一组和第二组均未发生多胎妊娠。讨论了这些策略对妊娠率和多胎妊娠发生率的影响。得出的结论是，将新鲜ET故意限制为最多一个胚胎，随后进行一个或多个解冻冷冻ET周期，对妊娠率无害，且与多胎妊娠的关联较小。相反，这一策略增加了实验室工作人员的工作量，并引发了某些伦理问题。
