Author/Editor		Došen, Marko; Vlaisavljević, Veljko; Kovačič, Borut
Title		Early miscarriage after single and double blastocyst transfer - An analysis of 1020 blastocyst transfers
Translated title		Zgodnji spontan splav po prenosu ene ali dveh blastocist - Analiza rezultatov 1020 prenosov blastocist
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 80, št. Suppl 1
Publication year		2011
Volume		str. I-72-I-87
Language		eng
Abstract		Background: Occurrence of early miscarriage in pregnancies accomplished by in vitro fertilisation procedures was studied, almost exclusively, in women in whom cleavage stage embryos were transferred. The primary objective of our retrospective study was to identify the factors predicting early miscarriage following the transfer of one or two blastocysts. Materials and Methods: Using the multivariate logistic regression model, we analyzed the parameters of 1020 sequential IVF/ICSI cycles with the transfer of one or two blastocysts, in which positive levels of ßhCG were observed. Age of the patient, fertilization method, number of retrieved oocytes, number of developed, frozen and transferred blastocysts and their quality were analyzed as possible predictors for early spontaneous miscarriage. Results: The overall frequency of biochemical pregnancies in the observed group of patients was 6.6 % (67/1020). Biochemical pregnancies occurred somewhat more frequently following the transfer of one, rather than two blastocysts (9.05 % (23/254) vs. 5.8 % (44/763)). The rate of early clinical miscarriage was 13.3 % (136/1020), with the rate of miscarriage higher following the transfer of one as opposed to two blastocysts (15.3 % (39/254) vs. 12.7(97/763)). If biochemical pregnancies and early clinical miscarriages were observed together, the rate of early pregnancy losses in the overall sample studied was 19.9 % (203/1020), following the transfer of one blastocyst 24.4 % (62/254) and following the transfer of two 18.4 % (141/763). Using the multivariate logistic regression, we demonstrated that statistically significant predictors for early spontaneous miscarriages were the patient's age (OR = 1.098; 95 % CI 1.057-1.140, P < 0.001), the number of blastocysts transferred (OR = 0.592; 95 % CI 0.412-0.851, P = 0.005), the quality of blastocysts transferred (OR=0.666; 95 % CI 0.468-0.949; P = 0.024), as well as the number of blastocysts frozen (OR = 0. (Abs. trunc. at 2000 ch.)
Summary		Izhodišča: V dosedanjih študijah o spontani prekinitvi nosečnosti po oploditvi z biomedicinsko pomočjo (OBMP) so večinoma preučevali le cikle IVF (oploditev in vitro) s prenosom zarodkov drugega ali tretjega dne po punkciji foliklov. Z našo retrospektivno raziskavo smo želeli ugotoviti, kateri dejavniki napovedujejo zgodnji spontani splav po prenosu ene ali dveh blastocist. Metode: Z multivariatno logistično regresijo smo analizirali 1020 nosečnosti, ki smo jih dosegli po prenosu ene ali dveh blastocist iz zaporednih IVF/ICSI postopkov. Kot možne napovednike SM smo ocenjevali starost zdravljenih žensk, način oploditve, število jajčnih celic, skupno število blastocist, število zamrznjenih blastocist ter število ter kakovost prenesenih blastocist. Rezultati: Delež biokemijskih nosečnosti pri ženskah, ki so zanosile po prenosu ene ali dveh blastocist, je znašal 6,6 % (67/1020), in sicer 9,05 % (23/254) po prenosu ene blastociste ter 5,8 % (44/763) po prenosu dveh blastocist. Delež zgodnjih kliničnih spontanih splavov je bil pogostejši po prenosu ene blastociste (15,3 % (39/254)) kot po prenosu dveh blastocist (12,7 % (97/763)), v celem vzorcu pa je znašal 13,3 % (136/1020). Do zgodnje izgube nosečnosti (biokemijska nosečnosti in/ali zgodnji klinični spontani splav) je prišlo v 24,4 % (62/254) pri zanositvah po prenosu ene blastociste in v 18,4 % (141/763) pri zanositvah po prenosu dveh blastocist (delež zgodnje izgube nosečnosti v celotnem vzorcu je znašal 19,9 % (203/1020)). Ob upoštevanju različnih spremenljivk smo dokazali, da so bile spremenljivke starost ženske (OR = 1,098; 95-odstotni IZ 1,057-1,140, P < 0,001), število prenesenih blastocist (OR = 0,592; 95-odstotni IZ 0,412-0,851, P = 0,005), kakovost prenesenih blastocist (OR =0,666; 95-odstotni IZ 0,468-0,949; P = 0,024) in število blastocist za zamrzovanje (OR = 0,912; 95-odstotni IZ 0,832-0,999; P = 0,048) statistično značilno povezani s SM. (Izvl. skrajšan na 2000 zn.)
Descriptors		BLASTOCYST FERTILIZATION IN VITRO