Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310006, People's Republic of China.
BMC Pregnancy Childbirth. 2022 Mar 29;22(1):264. doi: 10.1186/s12884-022-04606-1.
Two or more embryo transfers have been used to increase the success rate of live birth in traditional in vitro fertilization (IVF) strategy at the expense of increased risks of multiple pregnancy and adverse perinatal outcomes. The decision regarding the elective single embryo transfer or double embryo transfer remains inconclusive. The aim of this study was to investigate the risk factors for twin pregnancy in IVF.
Participants who underwent their first fresh IVF cycle where two cleavage stage embryos were transferred in Women's Hospital of Zhejiang University between January 2010 and December 2018 were included in this retrospective cohort study. The primary outcome was twin delivery. Secondary outcomes included preterm birth and low birth weight RESULTS: Fifteen thousand four hundred fifty-nine women were available for final analysis, in which 1511 women resulted in twin delivery and 4788 women had singleton delivery. Female age over 35 was associated with reduced rates of twin pregnancy compared with female age at or less than 35 (9.5% vs 25.1%, aRR = 0.38 (0.27. 0.55)). Poor-type endometrium was associated with reduced rates of twin pregnancy (19.2% vs 27.5%, aRR = 0.75 (0.58. 0.96)). Two good-quality embryos for transfer was associated with significantly higher rates of twin pregnancy compared with one good-quality or none good-quality embryo (26% vs 12.8% vs 9.3%, aRR = 0.56 (0.45. 0.70), aRR = 0.44(0.26. 0.74)). Female age over 35 and none or one good-quality embryo for transfer were associated with reduced rate of low birth weight and preterm birth.
Women with age over 35, poor-type endometrium, one good-quality embryo or none good-quality embryo were associated with reduced rate for twin pregnancy.
为了提高传统体外受精（IVF）活产率，已经采用了两次或更多次胚胎移植，这增加了多胎妊娠和不良围产期结局的风险。关于选择性单胚胎移植或双胚胎移植的决策尚无定论。本研究旨在探讨 IVF 中双胞胎妊娠的危险因素。
本回顾性队列研究纳入了 2010 年 1 月至 2018 年 12 月在浙江大学医学院附属妇产科医院进行首次新鲜 IVF 周期且移植两个卵裂期胚胎的患者。主要结局为双胎分娩。次要结局包括早产和低出生体重。
共有 15459 名女性最终进入分析，其中 1511 名女性分娩双胎，4788 名女性分娩单胎。与年龄在 35 岁及以下的女性相比，年龄超过 35 岁的女性双胎妊娠率较低（9.5% vs. 25.1%，aRR=0.38（0.27. 0.55））。子宫内膜不良型与双胎妊娠率降低有关（19.2% vs. 27.5%，aRR=0.75（0.58. 0.96））。与移植一个或无优质胚胎相比，移植两个优质胚胎与双胎妊娠率显著升高有关（26% vs. 12.8% vs. 9.3%，aRR=0.56（0.45. 0.70），aRR=0.44（0.26. 0.74））。年龄超过 35 岁和移植一个或无优质胚胎与低出生体重和早产率降低有关。
年龄超过 35 岁、子宫内膜不良、一个优质胚胎或无优质胚胎与双胎妊娠率降低有关。
