Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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The Comparison of Pregnancy Outcomes between Elective Two and Three Cleavage-state Embryos Transfer in Fresh IVF-ET

체외수정술시 난할단계 배아 2개와 3개를 이식했을 때의 임신예후의 비교

  • Lyu, Sang-Woo (Fertility Center of CHA Gangnam Medical Center, Department of Obstetrics and Gynecology, College of Medicine, CHA University) ;
  • Won, Hyung-Jae (Fertility Center of CHA Gangnam Medical Center, Department of Obstetrics and Gynecology, College of Medicine, CHA University) ;
  • Lee, Woo-Sik (Fertility Center of CHA Gangnam Medical Center, Department of Obstetrics and Gynecology, College of Medicine, CHA University) ;
  • Han, Ji-Eun (Fertility Center of CHA Gangnam Medical Center, Department of Obstetrics and Gynecology, College of Medicine, CHA University) ;
  • Kim, A-Ri (Fertility Center of CHA Gangnam Medical Center, Department of Obstetrics and Gynecology, College of Medicine, CHA University) ;
  • Kim, You-Shin (Fertility Center of CHA Gangnam Medical Center, Department of Obstetrics and Gynecology, College of Medicine, CHA University) ;
  • Seok, Hyun-Ha (Fertility Center of CHA Gangnam Medical Center, Department of Obstetrics and Gynecology, College of Medicine, CHA University) ;
  • Yoon, Tae-Ki (Fertility Center of CHA Gangnam Medical Center, Department of Obstetrics and Gynecology, College of Medicine, CHA University)
  • 유상우 (차의과대학교 차병원 여성의학연구소) ;
  • 원형재 (차의과대학교 차병원 여성의학연구소) ;
  • 이우식 (차의과대학교 차병원 여성의학연구소) ;
  • 한지은 (차의과대학교 차병원 여성의학연구소) ;
  • 김아리 (차의과대학교 차병원 여성의학연구소) ;
  • 김유신 (차의과대학교 차병원 여성의학연구소) ;
  • 석현하 (차의과대학교 차병원 여성의학연구소) ;
  • 윤태기 (차의과대학교 차병원 여성의학연구소)
  • Published : 2010.03.31
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Abstract

Objective: To compare the respective pregnancy outcomes of cycles undergoing elective two cleavage-stage embryos transfer (2ET) and three cleavage-stage embryos transfer (3ET) in fresh in vitro fertilization and embryo transfer (IVF-ET) program. Methods: We conducted a retrospective matched case control study that included 100 women with 2ET and 100 women with 3ET from January 2007 to June 2009. Subjects were matched for reproductive profiles and cycle characteristics. All of transferred embryos in both groups had good qualities. Pregnancy rates (PR), implantation rate, and multiple PR were compared. Results: Demographics, stimulation parameters and embryological data were comparable in both groups. Main pregnancy outcomes with 2ET and 3ET groups were not statistically different; implantation rate (41.0% vs. 35.3%), positive pregnancy rate (58.0% vs. 60.0%), clinical PR (55.0% vs. 59.0%), ongoing PR (51.0% vs. 55.0%), respectively. However, the 3ET group showed significantly higher multiple pregnancy and triplet pregnancy rates (30.9% vs. 50.8%, p=0.031; 1.8% vs. 11.9%, p=0.036, respectively). Conclusion: In women with favorable conditions and good quality embryos undergoing IVF, 2ET can get pregnancy outcomes comparable to those of 3ET and reduce multiple pregnancy (especially, triplet pregnancy).

목 적: 본 연구는 체외수정술에서 배양 3일째 2개의 난할단계 배아 (2ET)와 3개의 난할단계 배아 (3ET)를 이식했을 때 각각의 임신성적을 비교하기 위하여 시행하였다. 연구방법: 2007년 1월부터 2009년 6월까지 한 명의 불임전문 의사에게 시술받은 2ET군 100명을 환자의 나이와 체외수정 주기의 특성을 고려하여 3ET군 100명과 비교한 후향적 환자군-대조군 연구를 시행하였으며, 두 군 모두 양질의 배아만을 이식하였다. 각각의 임신율, 착상율, 다태임신율을 비교하였다. 결 과: 환자의 특성, 체외수정 주기 및 배아의 특징은 두 군 간에 차이를 보이지 않았다. 2ET군과 3ET군 모두 비슷한 임신성적을 보여주었다; 착상율 (41.0% vs. 35.3%), 임신율 (58.0% vs. 60.0%), 임상적임신율 (55.0% vs. 59.0%), 진행임신율 (51.0% vs. 55.0%). 두 군 모두 높은 다태임신율을 보여주었으나, 3ET군에서 유의하게 더 높은 전체 다태임신율과 삼태임신율을 보여주었다 (30.9% vs. 50.8%, p=0.031; 1.8% vs. 11.9%, p=0.036). 결 론: 나이가 ��고 양질의 배아를 가진 좋은 예후를 예측할 수 있는 여성에서 체외수정술 시행 시 배양 3일째 2개의 배아를 이식하더라도 3개의 배아를 이식했을 때와 비슷한 임신성적을 얻을 수 있고, 다태임신 (특히, 삼태임신)을 줄일 수 있다.

Keywords

References

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