降低辅助生殖技术中多胎妊娠的对策

Strategies to reduce multiple pregnancies in assisted reproductive technology

随着辅助生殖技术(assisted reproductive technology,ART)的迅速发展,众多不孕家庭借助体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)技术获得后代,但是多胚胎移植导致医源性多胎妊娠率显著增加,严重威胁母体和子代的生命健康。降低医源性多胎妊娠的根本性防范措施是降低IVF移植胚胎个数,实施单胚移植。目前,单胚移植被公认是改善母儿围产结局、减少卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)并发症、提高ART安全性的最佳策略和抉择,已成为全球ART治疗的趋势和目标。鉴于单胚移植降低IVF单周期妊娠率,其全面推行有赖于临床医生和胚胎学家的合作,通过促排方案的优化、提高胚胎发育潜能、优选高质量胚胎等多环节的技术改良,提高生殖中心整体的单胚移植妊娠结局。

With the development of assisted reproductive technology,in vitro fertilization and embryo transfer(IVF-ET)has successfully solved the problem of infertility for numerous families.However,the transfer of multiple embryos can result in iatrogenic multiple pregnancy,which seriously threatens the health of both the mother and offspring.The primary measure to reduce the risk is to reduce the number of embryos transferred during IVF procedures-implementing single embryo transfer(SET).At present,SET is widely recognized as an optimal strategy to improve maternal and perinatal outcomes,reduce complications of ovarian hyperstimulation syndrome(OHSS),and improve the safety of assisted reproductive technology(ART),and thus it has become a global trend and target of ART treatment.However,SET reduces the pregnancy rate of single embryo transfer cyclen,so its implementation depends on the cooperation between clinicians and embryologists to enhance the overall SET pregnancy outcomes through various technical improvements,such as optimization of the ovulation protocol,improvement of embryo developmental potential,and selection of high-quality embryos.