Demographic and Assisted Reproduction Related Factors Associated with Dichorionic Triplet Gestations

作     者：Barbara V. Parilla Brett Goldman Sue Jasulaitis Suela Sulo Angeline Beltsos 

作者机构：Department of Obstetrics and Gynecology Advocate Lutheran General Hospital Park Ridge USA Chicago Medical School North Chicago USA Fertility Centers of Illinois Chicago USA James R. & Helen D. Russell Institute for Research & Innovation Advocate Lutheran General Hospital Park Ridge USA 

出 版 物：《Open Journal of Obstetrics and Gynecology》 (妇产科期刊（英文）)

年 卷 期：2015年第5卷第13期

页      面：740-745页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Monochorionic Triplets Embryo Splitting 

摘      要：Our objective was to evaluate which demographic factors or assisted reproductive technologies were associated with IVF triplet gestations where one of the embryos split, resulting in a dichorionic triplet gestation. This was a case-control study of dichorionic versus trichorionic triplet gestations that underwent assisted reproductive technology over the last 5 years at our fertility center. There were 53 cases of dichorionic triamniotic triplet gestations compared to 119 trichorionic triplet controls. There were no significant demographic differences between the cases and controls. 51/53 dichorionic triplets and 86/119 trichorionic triplets were conceived through IVF, the remaining utilized intrauterine insemination. ICSI was performed in virtually all patients that underwent IVF. Of the potential risk factors studied, hatching was used in 70.6% of dichorionic compared to 89.5% of trichorionic IVF triplets (p = 0.005);embryo transfer was performed on Day 5 or 6 compared to Day 3 in 88.0% dichorionic vs 71.8% trichorionic (p = 0.028). Frozen sperm was utilized more frequently with dichorionic than with trichorionic triplets, 26.0% vs 10.9% (p 0.011). Only 4 (7.5%) of the IVF cases underwent pre-implantation genetics. Certain assisted reproductive technologies appear to be associated with embryo splitting and a dichorionic triplet gestation. More research is needed in this area to further elucidate these findings.