移植2个胚胎发生双胎妊娠的风险因素分析

目的 探讨1次移植2枚胚胎时发生双胎妊娠的风险因素.方法 回顾性分析2970例1次移植2个胚胎移植周期资料,其中新鲜胚胎移植周期1984例、冻融胚胎移植周期986例,应用多因素Logistic回归法分析发生双胎妊娠的风险因素,并比较年龄＜35岁和≥35岁,移植0、1、2个优质胚胎以及不同移植时机的移植周期双胎妊娠率.结果 (1)多因素Logistic回归分析发现女方年龄与双胎妊娠呈负相关(P＜0.01)、移植优质胚胎个数和冻融胚胎移植与双胎妊娠正相关(均P＜0.01);(2)新鲜胚胎移植周期和冻融胚胎移植周期的双胎妊娠率在女方年龄＜35岁组均显著高于≥35岁组(16.0％比8.0％,P＜0.01;26.9％比14.2％,P＜0.01);(3)新鲜胚胎移植周期移植2个优质胚胎的双胎妊娠率显著高于移植0个和1个优质胚胎组(19.1％比5.4％和11.0％,均P＜0.01);冻融胚胎移植周期移植2个优质胚胎的双胎妊娠率亦显著高于移植0个和1个优质胚胎组(32.7％比10.8％和20.7％,均P＜0.01);(4)冻融胚胎移植周期双胎妊娠率显著高于新鲜胚胎移植周期(24.7％比14.9％,P＜0.01).结论 女方年龄、移植优质胚胎个数和冻融胚胎移植是双胎妊娠发生的高危因素;在冻融胚胎移植技术成熟的中心,对于女方年轻的患者,在FET周期建议单优胚移植.

Risk factors associated with twin pregnancy in double embryo transfer

Objective To explore the risk factors associated with twin pregnancy in double embryo transfer.Methods A retrospective analysis was performed for 2970 double embryo transfer cycles,including 1984 cycles of fresh embryo transfer and 986 cycles of frozen-thawed embryo transfer (FET).Multiple factor Logistic regression was used.The twin pregnancy rate was studied in group of age ＜ 35 or age ≥ 35 years old,in group of zero,single or double high-quality embryos transferred and group of fresh embryo transfer or FET cycles.Results (1) There was a significantly negative correlation between women's age and twin pregnancy according to the analysis of multiple factor Logistic regression ( P ＜ 0.01 ).And a significantly positive correlation existed between the number of high-quality embryos transferred,FET and twin pregnancy (P ＜0.0l ) ; (2)the twin pregnancy rate of both fresh embryo transfer and FET cycles was higher in group of age ＜35 years than that in group of age ≥35 years ( 16.0％ vs 8.0％,P ＜0.01 ; 26.9％ vs 14.2％,P ＜0.01 ) ; (3) the twin pregnancy rate of fresh embryo transfer cycles with double high-quality embryos transferred was higher than that with zero or single high-quality embryos transferred ( 19.1％ vs 5.4％ ;19.1％ vs 11.0％,P ＜ 0.01 ); the twin pregnancy rate of FET cycles with double high-quality embryos transferred was also higher than that with zero or single high-quality embryos transferred (32.7％ vs 10.8％ ; 32.7％ vs 20.7％,P ＜0.01 ) ; (4)the twin pregnancy rate of FET cycles was significantly higher than that of fresh embryo transfer cycles (24.7％ vs 14.9％,P ＜0.01 ).Conclusion Women's age,the number of high quality embryos transferred and FET are risk factors associated with twin pregnancy.At reproductive centers with a mature technique of FET,we recommend performing single high-quality embryo transfer in FET cycles to reduce the occurrence of twin pregnancy.