在生育路上，大家或多或少都会遇到一些难题，今天我们翻译了CEF大咖，——美国试管婴儿教父Rizk教授的关于当今辅助生育技术现存争议。美国试管婴儿教父Botros Rizk，M.D，作为CFG全球医疗总监，同时也是CEF创始人、院长。他师从诺贝尔奖得主试管婴儿之父Robert Edwards，有40年执业从医经验，参与过10000+试管案例。 　　There were numerous previous statistics showing frozen embryo transfers have higher pregnancy rates than those of fresh embryos transfers.Therefore,people start to think that freeze-all policy applies to every situation and every single patient regardless of their different characteristics.However,Dr.Rizk delivered a speech themed“Controversy in ART”on the symposium at the 75th ASRM.
 
　　以往有大量的数据显示冻胚移植比鲜胚移植的成功率高，因此人们认为冻胚移植适用于所有类型的病人。然而，第75届ASRM大会当天，Dr.Rizk教授出席了学术座谈会，并发表了以“当今辅助生育技术现存争议”为主题的演讲。
 
　　Controversy现存争议
 
　　However,the truth is that freezing of all embryos in In Vitro Fertilization(IVF)is beneficial in high responders,but not intermediate and low responders who are of better outcome with fresh embryo transfers.The Meta-Analysis has divided patients into three groups.
 
　　Poor responders:1-5 eggs retrieved;
 
　　Intermediate responders:6-14 oocytes retrieved;
 
　　High responders:15+oocytes retrieved.
 
　　实际上，冻胚移植对于促排反应较好的病人来说较为有利;对于促排反应一般和较差的病人来说，鲜胚移植更适合。Meta分析研究把所有的病人分为了三组：
 
　　促排结果较差：取卵数1-5颗;
 
　　促排结果一般：取卵数6-14颗;
 
　　促排结果良好：取卵数15颗或以上。
 
　　Meta-Analysis(Meta分析法)：
 
　　There were total of 82,935 cycles completed,composing 69,102 fresh transfers,and 13,833“freeze all”followed by FET.
 
　　调研共由82,935个周期组成，其中包含69,102个鲜胚移植周期，及13,833个冻胚移植周期。 　　Conclusions(结论):
 
　　green stands for Fresh Embryo Transfer,aka Fresh ET;while blue stands for Frozen Embryo Transfer,aka FET：
 
　　绿色代表鲜胚移植，蓝色代表冻胚移植：
 
　　1.Freeze-all strategy is beneficial for pregnancy outcomes in high responders(15+oocytes retrieved),while for patients who are intermediate and poor responders,fresh transfer tend to be a better option;
 
　　数据表明，促排结果良好的病人更适合冻胚移植,促排结果一般和较差的病人更适合鲜胚移植;
 
　　2.In intermediate(6-14 oocytes retrieved)and low(1-5 oocytes retrieved)responders,clinical pregnancy and live birth rates are higher following fresh embryo transfer;
 
　　数据表明，促排结果较差和一般的病人鲜胚移植的临床妊娠率和婴儿活产率相比冻胚移植更高;
 
　　3.Birthweights are higher after FET vs fresh ET in infants born to high and intermediate responders.
 
　　数据表明，促排结果一般和良好的病人冻胚移植所诞生的婴儿初生重相比鲜胚移植更高。