在实施公共资助的生育计划后,多胎儿怀孕
Maria P Velez1,2, Allison Soule1, Laura Gaudet1
1Department of Obstetrics and Gynaecology, Queen's University, Kingston, Ontario, Canada.
JAMA network open
|April 25, 2024
概括
加拿大安大略省的一项公共资助的生育计划,在实施了用于体外受精 (IVF) 的选择性单胚移植 (eSET) 政策后,显著降低了多胎妊娠率. 然而,需要进一步的策略来降低这些排卵诱导和子宫内授精 (OI/IUI) 的率.
科学领域:
- 生殖医学 生殖医学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 加拿大安大略省在2015年推出了一项公共资助的生育计划.
- 该计划规定了用于体外受精 (IVF) 的选择性单个胚胎移植 (eSET) 政策.
- 之前的研究没有考虑胎儿减少或所有怀孕结果.
研究的目的:
- 检查生育治疗与多胎妊娠风险之间的关联.
- 在分析中考虑胎儿减少和所有活产/死产.
- 为了比较在eSET政策实施之前和之后的多胎妊娠率.
主要方法:
- 基于人口的,使用链接的行政卫生数据库进行回顾性队列研究.
- 从2006年到2021年,在安大略省检查了超过170万例怀孕.
- 使用修改Poisson回归方法,比较无助受孕,排卵诱导/子宫内授精 (OI/IUI) 和试管婴儿的结果.
主要成果:
- 多胎妊娠率为1.4% (无辅助),10.5% (OI / IUI) 和15.5% (IVF).
- 生育治疗显著增加了多胎妊娠的风险 (ARR:7.0对于OI/IUI,9.9对于IVF).
- 在eSET政策后,多胎妊娠率从IVF的29.4%降至7.1%,OI/IUI的12.9%降至9.1%.
结论:
- 一个公共资助的试管婴儿计划与eSET授权减少了多胎妊娠率.
- 需要持续的战略来进一步减少多胎妊娠,特别是OI/IUI.
- 该研究强调了政策对生育治疗结果和多胎妊娠风险的影响.
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