Ito Ayumu, Jwa Seung Chik, Kuwahara Akira, Ueda Akihiko, Ohashi Mai, Kawai Kiyotaka, Kitahara Yoshikazu, Habara Toshihiro, Katagiri Yukiko, Iwase Akira
Department of Obstetrics and Gynecology, Toho University Faculty of Medicine, Tokyo, Japan.
Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan.
J Obstet Gynaecol Res. 2025 May;51(5):e16304. doi: 10.1111/jog.16304.
To evaluate the impact of health insurance coverage for assisted reproductive technology (ART), introduced in Japan in April 2022, on the number of multiple embryo transfers (METs) and multiple pregnancies.
We analyzed Japanese ART registry data from over 600 registered ART facilities, comparing the rates and numbers of multiple pregnancies in 2022 with those in previous years. Furthermore, age-specific MET rates and proportions of blastocyst transfers in METs were examined separately for fresh and frozen-thawed embryo transfers.
In 2022, 3209 multiple pregnancies were reported, showing an increasing trend and a level equivalent to that in 2007, before single embryo transfer was recommended in the Japan Society for Obstetrics and Gynecology guidelines. For all embryo transfers, the MET rate was significantly lower in 2022 than in 2021, decreasing from 15.4% to 15.0% (p < 0.001), resulting in a similar rate of multiple pregnancies (2.98% vs. 3.05%; p = 0.17). Age-specific MET rates demonstrated a similar increasing trend with age between 2021 and 2022. However, the blastocyst utilization rate in METs was significantly higher in 2022 than in 2021 across almost all age strata in frozen-thawed embryo transfers.
In 2022, the MET rate significantly decreased from 2021, whereas the multiple pregnancy rate remained similar. However, the absolute number of multiple pregnancies increased to the level before the single embryo transfer guideline, and the proportion of blastocyst transfers in MET also increased. Continuous monitoring is necessary to capture trends in the number of multiple pregnancies following ART in Japan.
评估2022年4月在日本引入的辅助生殖技术（ART）医疗保险覆盖范围对多胚胎移植（METs）数量和多胎妊娠的影响。
我们分析了来自600多家注册ART机构的日本ART登记数据，比较了2022年与前几年的多胎妊娠率和数量。此外，还分别针对新鲜胚胎移植和冻融胚胎移植，检查了特定年龄的MET率以及MET中囊胚移植的比例。
2022年报告了3209例多胎妊娠，呈上升趋势，且达到了2007年的水平，即在日本妇产科学会指南推荐单胚胎移植之前的水平。对于所有胚胎移植，2022年的MET率显著低于2021年，从15.4%降至15.0%（p<0.001），导致多胎妊娠率相似（2.98%对3.05%；p=0.17）。2021年至2022年期间，特定年龄的MET率随年龄呈现出相似的上升趋势。然而，在冻融胚胎移植中，2022年几乎所有年龄层的MET中囊胚利用率均显著高于2021年。
2022年，MET率较2021年显著下降，而多胎妊娠率保持相似。然而，多胎妊娠的绝对数量增加到了单胚胎移植指南发布前的水平，MET中囊胚移植的比例也有所增加。有必要持续监测以掌握日本ART后多胎妊娠数量的趋势。
