(2)ARTによる多胎妊娠発生予知と移植胚数の減少に向けて(講演要旨,<特集>第59回シンポジウム2「多胎妊娠の予防と管理」)

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Multiple pregnancies are now the most common complication of assisted reproductive technology (ART). These pregnancies carry with them great medical, economic, social, ethical, and psychological consequences, resulting in a considerable increase in demands for neonatal intensive care facilities and hospital costs. The most important factor influencing the incidence of multiple pregnancies is the number of embryos transferred. To reduce triple or high-order multiple pregnancies, we established criteria for the elective double embryo transfer (eDET) at day 2 or day 3 by a retrospective analysis of triple pregnancies after ART as follows: age<40 years, a first treatment cycle and more than 3 good-quality embryos available for transfer. Following acceptable clinical application of the criteria for eDET, the criteria for elective single embryo transfer (eSET) was also established to reduce twin pregnancies by analyzing cases with successful implantation of all embryos transferred as follows: <36 years of age, a first treatment cycle and more than 2 good-quality embryos developed at least to the 4-cell stage at day 2, or 6-cell stage at day 3. So far, the strategy using eDET and eSET seems to be useful to limit the incidence of multiple pregnancies with maintaining acceptable pregnancy rates. The incidence of multiple pregnancy was 23.5% when a maximum of 3 embryos was transferred, while it decreased to 4.8% when the criteria for eDET and eSET was applied. Moreover, the pregnancy rate was 26.6% before the application of the criteria, while it was 38.2% after clinical application of the criteria. eDET and eSET can be highly recommended to avoid multiple pregnancies in subjects who met the criteria. Further studies applying blastocyst transfer for eDET or eSET should be carried out to im-prove the criteria.
2007-10-01

(2)ARTによる多胎妊娠発生予知と移植胚数の減少に向けて(講演要旨,<特集>第59回シンポジウム2「多胎妊娠の予防と管理」)

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