The objective of this study was to answer the question of whether a double instead of triple embryo transfer strategy in patients over 38 years would substantially reduce the number of multiple pregnancies while maintaining the chance of a term live birth at an acceptable level. A randomized controlled two-centre trial was performed. Forty-five patients, 38 years or older, were randomized. Double embryo transfer over a maximum of four cycles (DET group) or triple embryo transfer over a maximum of three cycles (TET group) was performed. The cumulative term live birth rate was 47.3% after four cycles in the DET group and 40.5% after three cycles in the TET group. The difference between the DET and the TET group was 6.8% in favour of the DET group (95% CI -25 to 38). The multiple pregnancy rates in the DET and TET group were 0% (95% CI 0 to 24) and 30% (95% CI 7 to 65) respectively (P = 0.05). In the DET patients, the mean number of treatment cycles was 2.9 compared with 2.1 in the TET group (P = 0.01). In women of 38 years and older, double embryo transfer after IVF may result in similar cumulative term live birth rates compared with triple embryo transfer, provided that a higher number of treatment cycles is accepted.

译文

这项研究的目的是回答以下问题: 在38岁以上的患者中采用双重而不是三重胚胎移植策略是否会大大减少多胎妊娠的数量,同时将足月活产的机会保持在可接受的水平。进行了一项随机对照的两中心试验。45名38岁或以上的患者被随机分组。进行了最多四个周期的双胚胎移植 (DET组) 或最多三个周期的三胚胎移植 (TET组)。在DET组中,在四个周期后47.3% 累积足月活产率,在TET组中,在三个周期后40.5%。DET和TET组之间的差异6.8% 有利于DET组 (95% CI -25至38)。DET组和TET组的多次妊娠率分别为0% (95% CI 0 ~ 24) 和30% (95% CI 7 ~ 65) (P = 0.05)。在DET患者中,平均治疗周期数与TET组的2.1相比2.9 (P = 0.01)。在38岁及以上的女性中,如果接受更多的治疗周期,IVF后的双胚胎移植可能会导致与三胚胎移植相似的累积足月活产率。

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