英文摘要 |
Objectives: To compare the outcomes of in vitro fertilisation (IVF) treatment before and after the 2007 IVF regulations in Taiwan by accessing data from the national assisted reproduction database. Methods: Clinical pregnancies (those with the foetal heartbeat detected), live births, miscarriage, fetal reduction, and ectopic pregnancy in the five years before and after the assisted reproduction act were assessed from the national assisted reproduction database. Analysis of variance, Chi-square test, and multivariate logistic regression of the generalized linear model were used to compare the outcomes before and after the implementation of the legislation. Results: A total of 83,264 IVF cycles performed between 2002 and 2012 were included in our analysis. After implementing the legislation, fewer embryos were transferred in IVF cycles, but higher percentages of gestational sacs, clinical pregnancies, and live births were achieved. The rates of miscarriages, ectopic pregnancy, and fetal reduction were significantly less in the post-legislation period than in the pre-legislation period. The multivariate analysis found that the odds of embryos reaching the gestational sacs, clinical pregnancies, and live births per cycle significantly increased by 31-35%; the odds of fetal reduction were decreased by 20%. Compared to single embryo transfer, double embryo transfer increases the odds of live births by 11%. Conclusions: This was the first study to focus on the reproductive outcomes of IVF in the five years before and after the legislation of the assisted reproduction act in Taiwan. The Assisted Reproduction Act limited the number of embryo transfers to four would increase the likelihood of live births and reduce the probability of fetal reduction, and there was still a need for further research to prove. We suggest that the legislation be revised to reduce the maximum number of embryo transfers in an IVF cycle from four to less based on our findings and previous studies. The government can encourage the development of IVF technology and deregulate medical allowances for every IVF cycle to promote fertility in Taiwan. |