体外受精-胚胎移植术形成单卵双胎因素Meta分析

目的 采用Meta分析方法研究体外受精-胚胎移植治疗中影响单卵双胎发生的相关因素。方法 利用计算机检索Cochrane图书馆、PubMed、Web of science、中国知网、维普、万方各数据库对截止2020年2月1日所有公开或未公开发表的中英文文献。制定纳入、排除标准，剔除不符合要求的研究，对不同治疗方式、囊胚移植及新鲜冻融胚胎移植导致的单卵双胎率进行meta分析。结果 分别比较在IVF-ET和ICSI(OR=0.66，95%CI为0.49~0.90，P=0.008）导致的单卵双胎发生率有统计学意义，新鲜胚胎移植周期和冻融胚胎移植周期(OR=0.92，95% CI为0.72~1.17，P=0.474）、FET周期中卵裂期和囊胚期(OR=0.88，95% CI为0.58~1.35，P=0.563）导致的单卵双胎率无统计学差异。结论 行ICSI技术造成单卵双胎率高于行IVF操作；囊胚期胚胎移植不增加MZT的风险。

Meta-analysis of the factors of monozygotic twins in IVF-ET

To investigate the relevant factors that influence the AＲT manipulation on twins ( MZT) . Methods Sixdatabases including the Cochrane Library，Pubmed，Web of Science，China Knowledge Infrastructure ( CNKI) ，Chinese Science and Technology Periodical Database ( VIP) ，and Wanfang Database ( WF) were searched for all public or non －published publications documented the incidence and risk factors of MZT. Eligible studies were selected according to the inclusion and exclusion criteria for meta － analysis by using Revman software. Meta － analysis was performed on the different treatment methods，blastocyst transfer and fresh frozen － thawed embryo transfer. Ｒesults The incidence of monozygotic twins caused by IVF － ET and ICSI ( OＲ = 0. 66，95% CI: 0. 49 － 0. 90，P = 0. 008) was statistically significant. There was no significant difference in the rate of monozygotic twins between fresh embryo transfer cycle and frozen thawed embryo transfer cycle ( OＲ = 0. 92，95% CI: 0. 72 － 1. 17，P = 0. 474) ，cleavage and blastocyst in FET cycle ( OＲ = 0. 88，95% CI: 0. 58 －1. 35，P = 0. 563) . Conclusion The rate of monozygotic twins in ICSI is higher than that in IVF operation. Blastocyst embryo transfer do not increase the risk of MZT.