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Li Kunming
Shanghai First Maternity and Infant Health Hospital
Chief Physician of the Department of Assisted Reproduction
Associate Professor, Doctoral Supervisor
Specializes in infertility and assisted reproductive technology: IVF, artificial insemination, and menstrual disorders, endometriosis, polycystic ovaries, etc.
Text/Li Kunming
Edited by Mesonne/Mona
Helping infertile friends get pregnant quickly, safely and comfortably has always been the ultimate goal of fertility doctors.
Everyone knows that I am a good-natured doctor, who will fully consider your demands, and many things can be discussed. Actually you know what? Before coming to Shanghai, I was also very macho, and even some stories happened because of it.
Forget it, digression, don't talk about this, or return to the matter of deliberative quantity. Some things can be discussed, such as the plan, such as the time point of the entry cycle, such as because of the epidemic offline treatment is not convenient to switch to online, I will try to meet your requirements, see your convenience.
But there are some things that are really not negotiable. For example, the number of embryo transfers, which involves some industry regulations and your obstetric safety, sorry, at this time, you must listen to me, I must overbearing the president.
Historical evolution of the number of embryo transfers
I started assisted reproduction in 2003, and because the overall success rate was not very high, it was realistic to increase the number of embryo transfers in order to increase the pregnancy rate.
At that time, up to three embryos could be placed, so the pregnancy rate of multiple births was still very high, after all, although the planting rate of a single embryo was not very high, the transfer of three embryos, twins and even three births still happened frequently.
Therefore, what fertility doctors often do is due to the overstimulation of the ovaries that occur in multiple pregnancies, to put ascites, although the patient is pregnant, but not a comfortable pregnancy, which is contrary to the current concept; there is also three-child fetal reduction, although we have practiced excellent fetal reduction technology, but fetal reduction is my least favorite surgery, fertility doctors are such ideas, constructive work has a sense of achievement, destructive things always feel imperfect.
Based on this concept, coupled with the embryo implantation rate in recent years has also been greatly improved, then Shanghai reproductive quality control stipulates that only one embryo is transferred for the first time, if there is no good pregnancy for the first time, under the premise of no multiple fetal contraindications, two embryos can be transferred for the second time, which fully ensures the safety of patients, and at the same time is relatively satisfied with the success rate, it can minimize the way of multiple pregnancies and ovarian overstimulation, thereby ensuring the safety of mothers and children.
Q:
What are the only conditions suitable for single embryo transplantation?
As we mentioned earlier, there is a prerequisite for the second transfer to transfer two embryos, that is, there are contraindications to pregnancy without multiple births. So what are the contraindications to multiple pregnancies?
It mainly includes the following situations: one-carobic uterus, double uterus, cervical insufficiency, cervical LEGP surgery history, uterine fibroid excision history, caesarean section history, bad pregnancy history (such as severe preeclampsia in the previous pregnancy, etc.), height of 150 cm and below, "three generations of test tubes".
If two embryos are transferred and a twin pregnancy occurs under the above circumstances, the risk of miscarriage, premature birth, uterine rupture, etc. may be increased, which in turn will affect the perinatal safety of the mother and child.
As a reproductive doctor, can not only care about the current pregnancy rate, but also consider the safety of pregnancy in October, in this case, just listen to the doctor's words, transfer an embryo, from the perspective of a single pregnancy rate, there is certainly no transfer of two embryos Pregnancy rate is high, but the live birth rate will be higher, the bad pregnancy rate will be lower, for the safety of you and the child, or listen to the advice of the reproductive doctor as well, please keep in mind, the doctor must be the person who wants you to be safe the most!
Now, the three-child policy has been liberalized, each time a child is actually the safest, brothers and sisters are a few years apart, but also more layered, the boss's clothes and toys can also be used for the second and third, save money and worry, why not enjoy it?
This article is reproduced from Dr. Li Kunming's popular science article, the copyright belongs to Dr. Li Kunming, if there is any infringement, please contact xiaobian to delete