Analysis Of The Effects Of Clinical Factors Of Multifetal Pregnancy Reduction (MFPR) On Pregnancy Outcome In 123 Cases

Objective:To evaluate and assess various clinical factors'effects on the pregnancy outcome of Multifetal Pregnancy Reduction (MFPR) patience through statistically analysis of clinical data collected from MFPR patients received ART treatment for infertility at Tong Ji Hospital.Methodology: Selected 123 cases of infertility patients received IVF/ICSI +ET assisted reproductive treatment from January 2002 to December 2009 in Reproductive Medicine Center of TongJi Hospital affiliated with TongJi Medical College of HuaZhong University of Science and Technology ,and statistically analyzed the associations between pregnancy outcome and various clinical factors including age, fertilizing style, fresh/ freeze–thaw embryo transfer (TET) cycle, MFPR timing, initial pregnant number and the number of remained fetuses after reduction.Results: Among the selected clinical index, MFPR timing and number of remained fetuses after reduction are significantly associated with pregnancy outcome of MFPR patients. The abortion rate of patients who underwent MFPR after 8 weeks pregnant is 64.29%, significantly higher than the abortion rate of patients who underwent MFPR before 8 weeks pregnant , which is 19.27%. After MFPR, the rate of spontaneous pregnancy reduction (SPR) occurred in first trimester is low, which is only 3.25%; The abortion rate of singleton pregnancy reduced from multiple pregnancy significantly decreases to 0.9%; In the patients who remain the singleton pregnancy and twin pregnancy reduced from multiple pregnancy , the gestational age is 37.1±2.6w, 35.7±2.48w respectively, and the fetal birth weight is 3.20±0.41kg,2.48±0.36kg respectively. There is no report about the fatal perinatal complications and fetal major malformations in the patients who remain singleton pregnancy after MFPR.Conclusions: During MFPR, fetus reduction timing and number of remained fetuses have significant impact on MFPR patient pregnancy outcome. The abortion rate of patients who underwent MFPR after 8 weeks pregnant significantly increases; After MFPR, the rate of spontaneous pregnancy reduction (SPR) occurred in first trimester is low, which is only 3.25%; The abortion rate of singleton pregnancy reduced from multiple pregnancy significantly decreases; the pregnancy outcome of singleton pregnancy is considerably better than twin pregnancy after MFPR. These factors have to be fully taken into consideration in clinical treatment. It is not advisable to overly delay MFPR operation to avoid the possibility of SPR after MFPR.