剩余胚胎处置方法的随访调查和伦理法律思考

Surplus embryo disposition follow-up investigation and ethical legal thinking

目的调查接受体外受精-胚胎移植(IVF-ET)技术助孕夫妇在结束治疗后对剩余冷冻胚胎的处置意愿,寻求剩余冷冻胚胎的适宜处置办法。方法对IVF-ET技术治疗后1~6年未返院处置剩余冷冻胚胎的672对夫妇,进行电话随访调查。结果 129对(19.2%)夫妇未能配合电话随访,543对(80.8%)夫妇接受电话随访调查。接受随访的夫妇中,38.1%(207/543)未明确是否来院办理相关手续,3.0%(16/543)拒绝来院办理相关手续;58.9%(320/543)承诺来院办理相关手续,截止发稿仅11.6%(63/543)夫妇返院。胚胎冻存时间<3年和3~6年被弃存的概率分别为43.8%和61.1%(P=0.000)。结论对于有剩余冷冻胚胎的患者再次随访确认是有必要的,呼吁各个生殖中心讨论生殖伦理相关问题,并形成专家共识来规范剩余冷冻胚胎的处置。

Objective To investigate the willingness of couples to dispose of remaining surplus embryos after treatment with In vitro fertilization-embryo transfer（IVF-ET）. Methods Within 1-6 years, 672 couples who did not return to the hospital for the disposition of the surplus embryos after the treatment of IVF-ET were followed up by telephone. Results After 672 telephone follow-up visits, 543 couples（80.8%） participated in the telephone follow-up survey, with 129 couples（19.2%） not participating in the survey. Of the couples who were followed up, 38.1%（207/543） did not specify whether come to the hospital for relevant procedures and 3.0%（16/543） refused to come to the hospital for relevant procedures; 58.9%（320/543） promised to come to the hospital for relevant procedures, and at present only 11.6%（63/543） of them returned to the hospital. The probability of embryo freezing in the period 3 years and 3-6 years was 43.8% and 61.1%（P=0.000）. Conclusion It is necessary for patients with residual surplus embryos to be followed up again, calling for the reproductive center to discuss related reproductive ethics and form the expert consensus to regulate the disposal of surplus frozen embryos.