年龄对辅助受孕转移胚胎数量的决定的影响:一项前性研究
Debbie A Lawlor1, Scott M Nelson
1MRC Centre for Causal Analysis in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol, UK.
Lancet (London, England)
|January 17, 2012
概括
选择性单个胚胎移植 (eSET) 建议所有接受体外受精 (IVF) 的女性进行,以减少多胎. 年龄应该指导胚胎移植决策,老年妇女可以从仔细考虑单个或双个胚胎移植中获益.
科学领域:
- 生殖医学 生殖医学
- 产科 产科 产科 产科 产科
- 周围生理学 周围生理学
背景情况:
- 选择性单个胚胎移植 (eSET) 旨在减少多胎出生和体外受精 (IVF) 后的不良结果.
- 关于eSET和产妇年龄的最佳策略仍然不清楚.
研究的目的:
- 调查围产期活产的结果是否根据与母亲年龄相关的转移胚胎数量而有所不同.
- 为了比较接受试管婴儿的年轻女性 (<40岁) 和年长女性 (≥40岁) 之间的活产,多胎产,低出生体重和早产率.
主要方法:
- 对英国人类受精和胚胎管理局数据的前性分析.
- 活产,多胎,低出生体重 (<2.5公斤),早产 (<37周) 和严重早产 (<33周) 的比较.
- 逻辑和二项回归用于评估相对风险和绝对风险差异.
主要成果:
- 对于40岁以上的女性来说,当转移两个胚胎而不是一个胚胎时,活产的几率更高,但绝对风险增加比年轻女性要小.
- 与年轻女性相比,老年女性的几率比率较小,多胎,早产和低出生体重的绝对风险差异较小.
- 转移三个胚胎并没有增加活产率,但增加了周围生育不良结果的风险.
结论:
- 对所有年龄段的人来说,强烈不建议转移3个或更多的胚胎.
- 胚胎移植决定 (一个或两个胚胎) 应纳入预后因素,如母亲的年龄.
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