Wu M Y, Chen S U, Chen H F, Chao K H, Chen C D, Ho H N, Huang S C, Lee T Y, Yang Y S
Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University Hospital, Taipei, ROC.
J Formos Med Assoc. 1996 Aug;95(8):617-22.
In order to achieve higher pregnancy rates, more than one embryo is usually transferred in in vitro fertilization (IVF) programs. Tubal embryo transfer (TET) produces an even higher pregnancy rate. However, the number of embryos that should be transferred in TET programs remains to be clarified. We studied a series of 241 consecutive TET cycles and analyzed their clinical characteristics, embryo numbers, cumulative embryo score (CES), and pregnancy outcomes. The results demonstrated that 1) four embryos was an adequate number to obtain a satisfactory pregnancy rate and fewer multiple pregnancies, 2) older patients and cases with male factor had less chance of pregnancy and more than four embryos could be transferred, and 3) CES values > 40 were preferred, but for young patients with unusually high anxiety about multiple pregnancies, a CES of 21 to 40 was optimal. A policy of transfer that limits transfer to a maximum of two, three or four embryos is not suitable in all cases and other factors (eg, repeated IVF failure or older age) should be individually considered. Therefore, two equations utilizing CES, age and failure of previous TET as the factors were developed to help practitioners to evaluate how many embryos should be transferred on an individual basis.
为了获得更高的妊娠率，体外受精（IVF）程序中通常会移植不止一个胚胎。输卵管胚胎移植（TET）的妊娠率更高。然而，TET程序中应移植的胚胎数量仍有待明确。我们研究了连续241个TET周期，并分析了它们的临床特征、胚胎数量、累积胚胎评分（CES）和妊娠结局。结果表明：1）四个胚胎是获得满意妊娠率和减少多胎妊娠的合适数量；2）年龄较大的患者和有男性因素的病例妊娠机会较少，可以移植超过四个胚胎；3）CES值>40更佳，但对于对多胎妊娠异常焦虑的年轻患者，CES为21至40是最佳的。限制移植最多两个、三个或四个胚胎的移植策略并不适用于所有情况，其他因素（如反复IVF失败或年龄较大）应单独考虑。因此，开发了两个以CES、年龄和先前TET失败为因素的方程，以帮助从业者评估个体应移植多少个胚胎。
