Abstract：
:In the early years of in vitro fertilization, overall pregnancy rates were low, and it was considered necessary to transfer more than one embryo to increase the chances of pregnancy. It was not until advances in assisted reproductive technologies resulting in increased pregnancy rates that the concept of transferring just one embryo was considered possible. A consequence of improvements in implantation rates was also an increase in multiple pregnancies when more than one embryo was transferred. Although some countries have reduced the number of embryos transferred, international data show that in many parts of the world high twin and higher order multiple pregnancy rates still exist. Even in developed countries these problems persist depending on clinical practice, funding of health services, and patient demands. Perinatal and other outcomes are significantly worse with twins compared with singleton pregnancies and there is an urgent need to reduce multiple pregnancy rates to at least 10%. This has been achieved in several countries and clinics by introducing single embryo transfer but there are many barriers to the introduction of this technique in most clinics worldwide. We discuss the background to the high multiple rate in assisted reproduction and the factors that contribute to its persistence even in excellent clinics and in high-quality health services. Practices that may promote single embryo transfer are discussed.
journal_name
Fertil Steriljournal_title
Fertility and sterilityauthors
Adamson GD,Norman RJdoi
10.1016/j.fertnstert.2020.09.003subject
Has Abstractpub_date
2020-10-01 00:00:00pages
680-689issue
4eissn
0015-0282issn
1556-5653pii
S0015-0282(20)32203-2journal_volume
114pub_type
杂志文章,评审abstract：:Mean monthly values for ejaculate volume, sperm density, and percentage of motile sperm were calculated from semen analyses performed on volunteered donors to the laboratory from 1979 to 1986. The data of 4,196 ejaculates were computerized by the single Cosinor method for searching on circannual rhythms of the paramet...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/s0015-0282(16)60738-0
更新日期：1989-06-01 00:00:00
abstract：OBJECTIVE:To determine the regulatory role of hCG on P secretion in normal and abnormal (abortive and ectopic) first trimester pregnancies. STUDY DESIGN:The number of doublings of hCG per day (1/DT; reciprocal of hCG doubling time) was correlated with serum P using linear and nonlinear models in normal intrauterine pr...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/s0015-0282(16)56876-9
更新日期：1994-08-01 00:00:00
abstract：:To evaluate the effectiveness of intravenous metoclopramide, alone or in combination with luteinizing hormone-releasing hormone (LH-RH), in distinguishing between constitutional delay of puberty and hypogonadotropic hypogonadism, 12 patients with constitutional delay of puberty and 10 patients with hypogonadotropic hy...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/s0015-0282(16)60788-4
更新日期：1989-07-01 00:00:00
abstract：OBJECTIVE:To describe patients who at least once did not reply to correspondence of the center about embryo disposition. DESIGN:Anonymous questionnaire. SETTING:Department of Reproductive Medicine, Ghent University Hospital (Belgium). PATIENT(S):Patients whose embryos were stored for at least 2 years. INTERVENTION(...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/j.fertnstert.2011.02.033
更新日期：2011-05-01 00:00:00
abstract：OBJECTIVE:To measure skin wrinkles and rigidity in menopausal women of varying race/ethnicity with or without hormone therapy (HT) for up to four years. DESIGN:Randomized, double-blind, placebo-controlled trial. SETTING:Academic medical centers. PATIENT(S):Women (42-58 years of age) within 36 months of last menstrua...
journal_title：Fertility and sterility
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.fertnstert.2016.06.023
更新日期：2016-10-01 00:00:00
abstract：OBJECTIVE:To describe a case of primary infertility associated with oocytes having one pronucleus before fertilization on repeated IVF attempts. DESIGN:Case report. SETTING:A university-based assisted reproduction unit. PATIENT(S):A 30-year-old woman with primary infertility and oocytes containing one pronucleus bef...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/s0015-0282(02)04852-5
更新日期：2003-04-01 00:00:00
abstract：OBJECTIVE:To quantify the effect of the new 2010 World Health Organization (WHO) semen analysis reference values on reclassifying previous semen analysis parameters and definition of patients with male factor infertility. DESIGN:A multi-institutional retrospective chart review. SETTING:University and private male inf...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/j.fertnstert.2012.07.1130
更新日期：2012-12-01 00:00:00
abstract：OBJECTIVE:To assess whether gonadotropin-induced changes in E(2) alter serum levels of soluble vascular cell adhesion molecule-1 (sVCAM-1) and proinflammatory cytokines. DESIGN:Prospective collection of serum in patients undergoing IVF. SETTING:University hospital. PATIENT(S):Twenty-four infertile women. INTERVENTI...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/j.fertnstert.2008.04.039
更新日期：2009-05-01 00:00:00
abstract：OBJECTIVE:To assess fertility counseling and preservation practices among children, adolescents, and young adults with rheumatic diseases undergoing cyclophosphamide (CTX) treatment. DESIGN:Retrospective chart review (2006-2016). SETTING:Academic pediatric center. PATIENT(S):Male and female patients with systemic lu...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/j.fertnstert.2016.07.1102
更新日期：2016-11-01 00:00:00
abstract：:This retrospective study examined the association of endometrial pattern and pregnancy after a day 5 ET. The pregnancy rate of women with a triple-line ultrasound endometrial pattern on the day of hCG administration was significantly higher than the pregnancy rate of women with the other ultrasound patterns. This obse...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/j.fertnstert.2004.05.102
更新日期：2005-01-01 00:00:00
abstract：OBJECTIVE:To investigate whether temporarily withholding FSH and adding androgen could improve follicular response during a microdose flare protocol in women with slow follicular growth or asynchronous follicular development. DESIGN:Observational pilot study. SETTING:University-affiliated private fertility center. P...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/j.fertnstert.2015.09.038
更新日期：2016-01-01 00:00:00
abstract：:This paper reports further observations on our previous study of 203 Copper 7 intrauterine insertions performed in 199 women. There have now been accumulated 3799 woman-months of use. At least a 2-year period of observation has been attained from first insertion until these data were analyzed. The Copper 7 intrauterin...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：
更新日期：1978-11-01 00:00:00
abstract：:The authors evaluated 774 endometrial biopsies that were performed for infertility. Complications arose in 3.6%. Lag of more than 2 days was found in 19%; luteal phase defect (LPD) was diagnosed in 5.7%. Most of the incidence of LPD can be predicted from chance occurrence. There was no association between abnormal bio...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/s0015-0282(16)59528-4
更新日期：1987-11-01 00:00:00
abstract：OBJECTIVE:To determine the impact of a cryopreservation program on pregnancy rates and multiple-pregnancy rates in ART cycles. DESIGN:Retrospective study. SETTING:University teaching hospital. PATIENT(S):Women who underwent stimulation for in vitro fertilization at the Jones Institute for Reproductive Medicine betwe...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/s0015-0282(00)01661-7
更新日期：2001-01-01 00:00:00
abstract：:During hysteroscopy the uterus may be distended with carbon dioxide (CO2), nitrous oxide (N2O), or Hyskon (a high molecular weight dextran). An initial study in 27 patients (group 1) using arterialized venous blood samples demonstrated rises in carbon dioxide tension (PCO2) when N2O was insufflated by using a laparosc...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/s0015-0282(16)44179-8
更新日期：1979-08-01 00:00:00
abstract：:Different protocols using agonists of GnRH-a have been proposed for the ovarian stimulation in IVF cycles. In case of stimulation failure with the flare-up protocol, we have investigated whether an immediate switch to pituitary blockade by the long-acting analog may avoid the cycle to be canceled. This procedure allow...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/s0015-0282(16)53536-5
更新日期：1990-05-01 00:00:00
abstract：OBJECTIVE:The response to subcutaneous (SC) gonadotropin replacement therapy, using human chorionic gonadotropin (hCG) and human menopausal gonadotropin (hMG) or hCG alone, was evaluated in male hypothalamic hypogonadism. DESIGN:Sixteen patients with hypothalamic hypogonadism were treated with gonadotropins for induct...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/s0015-0282(16)54493-8
更新日期：1991-08-01 00:00:00
abstract：OBJECTIVE:To determine the effects of a low-dose mifepristone regimen on endometrium in the rhesus monkey by endometrial staging and analysis of molecular markers of endometrial receptivity. DESIGN:A prospective, randomized comparative study. SETTING:Academic research environment. ANIMAL(S):Normally cycling rhesus (...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/s0015-0282(00)00551-3
更新日期：2000-07-01 00:00:00
abstract：OBJECTIVE:To evaluate tubal morphology, trophoblast proliferation, and inflammatory reaction in response to methotrexate (MTX) treatment of ectopic pregnancy (EP). DESIGN:Nonrandomized controlled study. SETTING:Academic hospital. PATIENTS:Archival specimens from 10 EP unsuccessfully treated with MTX and 10 cases pri...
journal_title：Fertility and sterility
pub_type： 临床试验,杂志文章
doi：
更新日期：1996-04-01 00:00:00
abstract：:Plasma concentrations of luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), testosterone (T), and 17 beta-estradiol (E2) have been measured in men complaining of infertility in comparison with men of proven fertility. Subgrouping of patients was achieved on the basis of the presence or abse...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/s0015-0282(16)46582-9
更新日期：1982-10-01 00:00:00
abstract：OBJECTIVE:To evaluate and compare transforming growth factor β3 (TGF-β3) serum concentration in patients with uterine fibroids (UFs) without hormone treatment, treated with ulipristal acetate (UPA), and controls; to evaluate TGF-β3 concentrations in UF tissue in patients without hormone treatment and those treated with...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/j.fertnstert.2017.11.023
更新日期：2018-03-01 00:00:00
abstract：:Because spermatocyte meiotic error results in embryonic sex chromosomal aneuploidy, it is speculated that teratospermia correlates with increased embryonic sex chromosomal abnormalities. Our findings contradict this theory, suggesting that morphology does not correlate with sex chromosomal genotype. ...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/j.fertnstert.2009.07.1006
更新日期：2010-02-01 00:00:00
abstract：OBJECTIVE:To establish the prevalence of endometriosis metastatic to pelvic sentinel lymph nodes (PSLN) in women with ovarian and/or peritoneal endometriosis. DESIGN:Prospective clinical study. SETTING:Academic research institution. PATIENT(S):Women with a laparoscopic diagnosis of ovarian and/or peritoneal endometr...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/j.fertnstert.2011.06.070
更新日期：2011-09-01 00:00:00
abstract：:Our article endeavors to be both a review of the recent past and a preview of the future of reproductive surgery. By reflecting on the rate of technological advancement over the past decade, we attempt to predict the trajectory of the next. We also delve into the changing nature and practical challenges of the practic...
journal_title：Fertility and sterility
pub_type： 杂志文章,评审
doi：10.1016/j.fertnstert.2019.06.034
更新日期：2019-08-01 00:00:00
abstract：OBJECTIVE:To report the feasibility of ovarian cyst enucleation by using a laparoendoscopic single-site trocar through a transumbilical access. DESIGN:Case reports. SETTING:Teaching and research hospital. PATIENT(S):Three patients affected by large ovarian cysts. INTERVENTION(S):Enucleation of three large ovarian c...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/j.fertnstert.2009.05.060
更新日期：2009-09-01 00:00:00
abstract：OBJECTIVE:To evaluate the efficacy of the second micro-testicular sperm extraction (TESE)in men with nonobstructive azoospermia in whom the first micro-TESE failed. DESIGN:Retrospective. SETTING:Private clinic. PATIENT(S):One hundred twenty-five men with nonobstructive azoospermia with failed previous micro-TESE. Th...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/j.fertnstert.2020.10.005
更新日期：2020-12-23 00:00:00
abstract：OBJECTIVE:To obtain proof-of-concept that locally produced anti-inflammatory steroids suppress ovulation-associated extracellular matrix proteases in human ovarian surface epithelial (OSE) cells. DESIGN:Primary OSE cell cultures treated with interleukin-1alpha (IL-1alpha) (500 pg/mL) as proxy for inflammation, with/wi...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/j.fertnstert.2008.06.040
更新日期：2009-08-01 00:00:00
abstract：OBJECTIVE:To analyze the protein production into the surrounding medium (secretome) of both human and mouse embryos and correlate these findings with ongoing blastocyst development. Along with improvements in culture systems, there is renewed focus on the development of noninvasive viability assays in human IVF. Becaus...
journal_title：Fertility and sterility
pub_type： 杂志文章
doi：10.1016/j.fertnstert.2006.05.022
更新日期：2006-09-01 00:00:00
abstract：:Fifty healthy women, aged 18-39 years with no known risk of ovarian hyperstimulation were treated with 100 or 150 μg corifollitropin alfa (dependent on body weight) in a long GnRH agonist protocol. At these doses, corifollitropin alfa initiated and supported growth of a large cohort of follicles during the first week ...
journal_title：Fertility and sterility
pub_type： 临床试验,杂志文章
doi：10.1016/j.fertnstert.2009.12.070
更新日期：2010-10-01 00:00:00
abstract：OBJECTIVE:To determine whether there is significant quality of life score improvement after uterine artery embolization (UAE) and to compare UAE and myomectomy outcomes. DESIGN:Prospective cohort controlled study. SETTING:Sixteen medical centers in the United States. PATIENT(S):One hundred forty-nine UAE patients an...
journal_title：Fertility and sterility
pub_type： 杂志文章,多中心研究
doi：10.1016/j.fertnstert.2005.05.074
更新日期：2006-01-01 00:00:00
