TY - JOUR
T1 - Analysis of 122 triplet and one quadruplet pregnancies after single embryo transfer in Japan
AU - Yamashita, Satoko
AU - Ikemoto, Yuko
AU - Ochiai, Asako
AU - Yamada, Satoshi
AU - Kato, Keiichi
AU - Ohno, Motoharu
AU - Segawa, Tomoya
AU - Nakaoka, Yoshiharu
AU - Toya, Mayumi
AU - Kawachiya, Satoshi
AU - Sato, Yoshiaki
AU - Takahashi, Toshifumi
AU - Takeuchi, Shigeto
AU - Nomiyama, Mari
AU - Tabata, Chisa
AU - Fujiwara, Toshihiro
AU - Okamoto, Sumihide
AU - Kawamura, Toshihiro
AU - Kawagoe, Jun
AU - Yamada, Mitsutoshi
AU - Sato, Yuichi
AU - Marumo, Genzo
AU - Sugiyama, Rikikazu
AU - Kuroda, Keiji
N1 - Funding Information:
We wish to thank all Japanese reproductive doctors who registered the data in Japanese ART registry and contributed to the decrease in multiple pregnancies using SET procedure. We also thank JSOG for providing the ART data in 2007–2014 and the facilities that participated in our questionnaire survey; ART Okamoto Womenʼs Clinic, Denentoshi Ladies Clinic, Fukushima Medical University, Hanabusa Womenʼs Clinic, IVF Nanba Clinic, Juntendo University, Kato Ladies Clinic, Keio University, Kobe Motomachi Yume Clinic, Kyono ART Clinic, Matsusaka General Hospital, Saint Mother Hospital, Sanno Hospital, Shinbashi Yume Clinic, Sophia Ladies Clinic, Sugiyama Clinic Setagaya, Sugiyama Clinic Shinjuku, Takagi Hospital, and Takasaki ART Clinic (in alphabetic order).
Publisher Copyright:
© 2019 Reproductive Healthcare Ltd.
PY - 2020/3
Y1 - 2020/3
N2 - Research question: What is the prevalence of triplet and quadruplet pregnancies after single embryo transfer (SET) in Japan. Design: A retrospective observational study was conducted on 274,605 pregnancies after 937,848 SET cycles in registered assisted reproductive technology (ART) data from the Japanese ART national registry database between 2007 and 2014. A questionnaire survey of ART centres was also conducted. Data on pregnancies with embryo division into three or more after SET were analysed. Results: According to the Japanese ART national registry database, SET resulted in 109 triplet pregnancies (0.04% of pregnancies), and the questionnaire reports from 31 centres revealed 33 triplet and one quadruplet pregnancies. After exclusion of 20 duplicated cases, 122 triplet and one quadruplet pregnancies included 46 monochorionic (one gestational sac [37.4%]), 18 dichorionic (two gestational sacs [14.6%]) and 59 trichorionic pregnancies (three gestational sacs [48.0%]). Compared with singleton pregnancies, patients with monozygotic triplet or quadruplet pregnancies were less frequently diagnosed with unexplained infertility (P = 0.004), more often received gonadotrophin injections for ovarian stimulation in 39 cases with information available (P = 0.021) and underwent more blastocyst transfers and assisted hatching (P = 0.002 and P < 0.001, respectively). The proportion of live birth, defined as at least one baby born, excluding induced abortion, was 64.6% (73/116 pregnancies) of monozygotic triplet or quadruplet pregnancies. Conclusions: Combined Japanese ART national registry and survey data revealed 122 triplet and one quadruplet pregnancies, the majority after cryopreserved embryo transfer. Most were conceived after blastocyst transfer and often after assisted hatching, which are potential risk factors for zygotic splitting.
AB - Research question: What is the prevalence of triplet and quadruplet pregnancies after single embryo transfer (SET) in Japan. Design: A retrospective observational study was conducted on 274,605 pregnancies after 937,848 SET cycles in registered assisted reproductive technology (ART) data from the Japanese ART national registry database between 2007 and 2014. A questionnaire survey of ART centres was also conducted. Data on pregnancies with embryo division into three or more after SET were analysed. Results: According to the Japanese ART national registry database, SET resulted in 109 triplet pregnancies (0.04% of pregnancies), and the questionnaire reports from 31 centres revealed 33 triplet and one quadruplet pregnancies. After exclusion of 20 duplicated cases, 122 triplet and one quadruplet pregnancies included 46 monochorionic (one gestational sac [37.4%]), 18 dichorionic (two gestational sacs [14.6%]) and 59 trichorionic pregnancies (three gestational sacs [48.0%]). Compared with singleton pregnancies, patients with monozygotic triplet or quadruplet pregnancies were less frequently diagnosed with unexplained infertility (P = 0.004), more often received gonadotrophin injections for ovarian stimulation in 39 cases with information available (P = 0.021) and underwent more blastocyst transfers and assisted hatching (P = 0.002 and P < 0.001, respectively). The proportion of live birth, defined as at least one baby born, excluding induced abortion, was 64.6% (73/116 pregnancies) of monozygotic triplet or quadruplet pregnancies. Conclusions: Combined Japanese ART national registry and survey data revealed 122 triplet and one quadruplet pregnancies, the majority after cryopreserved embryo transfer. Most were conceived after blastocyst transfer and often after assisted hatching, which are potential risk factors for zygotic splitting.
KW - Assisted reproductive technology
KW - Monozygotic quadruplet
KW - Monozygotic triplet
KW - Multiple pregnancy
KW - Single embryo transfer
KW - Zygotic splitting
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U2 - 10.1016/j.rbmo.2019.11.008
DO - 10.1016/j.rbmo.2019.11.008
M3 - Article
C2 - 32033910
AN - SCOPUS:85078861196
SN - 1472-6483
VL - 40
SP - 374
EP - 380
JO - Reproductive BioMedicine Online
JF - Reproductive BioMedicine Online
IS - 3
ER -