Paffoni Alessio, Cesana Sabrina, Corti Laura, Wyssling Hilda, Kunderfranco Alessandro, Bianchi Marco Claudio
UOSD Infertility Unit, ASST Lariana, via Domea, 22063 Cantù, Como Italy.
J Obstet Gynaecol India. 2023 Aug;73(4):329-335. doi: 10.1007/s13224-023-01768-6. Epub 2023 Jun 7.
To evaluate whether elective single embryo transfer in patients with suboptimal response to ovarian stimulation is detrimental to pregnancy rates compared to double embryo transfer.
A case-control retrospective study was performed in a cohort of couples undergoing IVF at the Infertility Unit of the ASST Lariana with ≤ 9 oocytes and at least 2 viable embryos. A total of 424 women were analyzed in the "double embryo transfer" group ( = 212) and elective "single embryo transfer" group ( = 212); they were matched 1:1 for female age, ovarian reserve and number of previous cycles. Cumulative clinical pregnancy rate per oocyte retrieval was the main outcome.
The cumulative pregnancy rate per cycle, including the fresh embryo and subsequent frozen embryo transfers, was 26% and 26%, respectively. Considering the main confounding factors, a binomial logistic model indicated that the cumulative clinical pregnancy rate was not significantly affected when a single embryo transfer was performed in women recovering up to nine oocytes.
Live birth rate was similar between the two groups, while twin pregnancies were significantly reduced in women receiving single embryo transfer suggesting that elective single embryo transfer in patients with a limited number of embryos is not detrimental to pregnancy rates.
评估与双胚胎移植相比，对卵巢刺激反应欠佳的患者进行选择性单胚胎移植是否会对妊娠率产生不利影响。
在ASST拉里亚纳不孕症科对一组接受体外受精的夫妇进行病例对照回顾性研究，这些夫妇有≤9个卵母细胞且至少有2个可存活胚胎。“双胚胎移植”组（n = 212）和选择性“单胚胎移植”组（n = 212）共分析了424名女性；根据女性年龄、卵巢储备和既往周期数进行1:1匹配。每次取卵的累积临床妊娠率是主要结局指标。
每个周期的累积妊娠率，包括新鲜胚胎移植和随后的冷冻胚胎移植，分别为26%和26%。考虑到主要混杂因素，二项逻辑模型表明，对于回收卵母细胞数达9个的女性进行单胚胎移植时，累积临床妊娠率未受到显著影响。
两组的活产率相似，而接受单胚胎移植的女性双胎妊娠显著减少，这表明对胚胎数量有限的患者进行选择性单胚胎移植对妊娠率没有不利影响。
