Retrospective analysis of outcomes of selectively or spontaneously reduced multiple pregnancies out of 6917 in vitro fertilization-embryo transfer pregnancy cycles
10.3760/cma.j.issn.0529-567x.2017.03.004
- VernacularTitle:6917个体外受精-胚胎移植临床妊娠周期中多胎妊娠选择性或自然减胎后的妊娠结局及新生儿情况
- Author:
Qiaoli CHEN
;
Hong YE
;
Xiaoyan DING
;
Xiaoli SHEN
;
Guoning HUANG
- Keywords:
Fertilization in vitro;
Embryo transfer;
Pregnancy reduction;
multifetal;
Pregnancy outcome;
Pregnancy trimester;
first;
Infant;
newborn
- From:
Chinese Journal of Obstetrics and Gynecology
2017;52(3):159-163
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the effects of fetal reduction in early pregnancy on obstetric and neonatal outcomes of spontaneously or selectively reduced multiple pregnancies produced by in vitro fertilization-embryo transfer (IVF-ET). Methods Retrospective study of 6917 clinical pregnancies from IVF-ET cycles, including 754 multiple pregnancies divided into two groups according to the remaining fetus number: reduced singleton group (n=599) and reduced twin group (n=155); and maternal and neonatal outcomes of two groups were compared to primary singleton group (n=3589) and primary twin group (n=2574). Results The rate of pregnancy complication [9.85%(59/599) versus 6.21%(223/3589)], preterm birth [19.37%(116/599) versus 10.73%(385/3589)], low birth weight [9.71%(56/577) versus 4.57%(152/3324)], perinatal death [0.69%(4/577) versus 0.12%(4/3324)] and malformation [2.95%(17/577) versus 1.02%(34/3324)] in reduced singleton group were significantly higher than those in primary singleton group (all P<0.01). There were no significant differences between reduced twin group and primary twin group (all P>0.05). In reduced singleton group, birth defect rate was 2.95%, which was higher than those of the other three groups (P<0.05), in this group spontaneous pregnancy reduction accounted for 89.3%(535/599). Conclusions (1) The rate of pregnancy complication, preterm birth, low birth weight, perinatal death and malformation in reduced singleton group are still higher than primary singletons, suggesting embryo reduction only is a compensated method in multiple pregnancies. Limiting the number of embryos transferred is the essential solution. (2) The rate of birth defect in spontaneous pregnancy reduction group is higher, so prenatal examination should be reinforced in this group.
