Massachusetts General Hospital Fertility Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts.
Fertil Steril. 2022 Jun;117(6):1246-1254. doi: 10.1016/j.fertnstert.2022.03.005. Epub 2022 Apr 23.
To compare the obstetric and perinatal outcomes of deliveries conceived with embryos from single-step vs. sequential culture media systems.
Historical cohort of Massachusetts vital records linked to assisted reproductive technology clinic data from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System and laboratory embryology data from two large academic hospital fertility centers.
Not applicable.
Patients with singleton live birth deliveries between 2004 and 2017 conceived with autologous assisted reproductive technology cycles with fresh blastocyst transfer using either single-step (n = 1,058) or sequential (n = 474) culture media systems.
None.
Associations of single-step vs. sequential culture with obstetric outcomes (mode of delivery, placental abnormalities, pregnancy-induced hypertension, and gestational diabetes) and perinatal outcomes (preterm birth, low birthweight, small-for-gestational-age, and large-for-gestational-age [LGA]) were assessed with multivariate logistic modeling, adjusted for maternal age, race/ethnicity, education, parity, insurance type, protein supplementation, oxygen concentration, fertilization method, and number of transferred embryos.
Compared with sequential culture, single-step culture was associated with increased odds of LGA (adjusted odds ratio 2.1, 95% confidence interval 1.04-4.22). There were no statistically significant differences between single-step and sequential culture media systems in the odds of placental abnormalities, pregnancy-induced hypertension, gestational diabetes, prematurity, small-for-gestational-age, or low birthweight.
Single-step culture is associated with increased odds of LGA, indicating that embryo culture media systems may affect perinatal outcomes.
比较使用一步法和序贯法培养体系的胚胎进行分娩的产科和围产期结局。
将马萨诸塞州生命记录中的历史队列与辅助生殖技术诊所数据从辅助生殖技术协会诊所结局报告系统、两个大型学术医院生育中心的实验室胚胎学数据相联系。
不适用。
2004 年至 2017 年间接受自体辅助生殖技术周期新鲜囊胚移植的单胎活产分娩患者，使用一步法（n=1058）或序贯法（n=474）培养体系。
无。
比较一步法和序贯法与产科结局（分娩方式、胎盘异常、妊娠高血压和妊娠期糖尿病）和围产儿结局（早产、低出生体重、小于胎龄儿和大于胎龄儿[LGA]）的相关性，采用多元逻辑回归模型进行调整，调整因素包括母亲年龄、种族/民族、教育程度、产次、保险类型、蛋白质补充、氧浓度、受精方法和移植胚胎数量。
与序贯培养相比，一步法培养与 LGA 的发生几率增加相关（调整后的优势比 2.1，95%置信区间 1.04-4.22）。在胎盘异常、妊娠高血压、妊娠期糖尿病、早产、小于胎龄儿或低出生体重的几率方面，一步法和序贯培养体系之间没有统计学上的显著差异。
一步法培养与 LGA 的发生几率增加相关，这表明胚胎培养体系可能会影响围产儿结局。
