Incidence of monozygotic twinning with blastocyst transfer compared to cleavage-stage transfer

被引:168
作者
Milki, AA [1 ]
Jun, SH [1 ]
Hinckley, MD [1 ]
Behr, B [1 ]
Giudice, LC [1 ]
Westphal, LM [1 ]
机构
[1] Stanford Univ, Sch Med, Dept Gynecol & Obstet, Stanford, CA 94305 USA
关键词
blastocyst transfer; monozygotic twinning; cleavage stage transfer; multiple gestations; IVF;
D O I
10.1016/S0015-0282(02)04754-4
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To evaluate the incidence of monozygotic twinning (MZT) in pregnancies conceived after blastocyst transfer compared to cleavage-stage transfer. Design: Retrospective study. Setting: University IVF program. Patient(s): All IVF patients with viable pregnancies conceived during a 4-year period. Intervention(s): Blastocyst transfer or day 3 ET. Main Outcome Measure(s): Incidence of MZT assessed by transvaginal ultrasound. Result(s): There were 11 incidences of MZT in 197 viable pregnancies (5.6%) with blastocyst transfer compared to 7 of 357 viable pregnancies (2%) with day 3 ET. In 10 of 18 pregnancies, MZT was observed in the setting of a higher order multiple gestation (6 of 11 for blastocyst transfer and 4 of 7 for day 3 ET). In the day 3 ET group, assisted hatching or intracytoplasmic sperm injection (ICSI) did not increase MZT (4 of 213, 1.9%) compared to cycles without zona breaching (3 of 144, 2.1%). Similarly, in the blastocyst-transfer group, ICSI did not increase the incidence of MZT (4 of 74, 5.5% for ICSI and 7 of 123, 5.7% for non-ICSI IVF). Conclusion(s): Compared to day 3 ET, blastocyst transfer appears to significantly increase the incidence of gestations with MZT. This information should be taken into account when counseling patients about the pros and cons of extended culture.
引用
收藏
页码:503 / 506
页数:4
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