Author/Editor     Meden-Vrtovec, Helena; Virant-Klun, Irma; Tomaževič, Tomaž; Zorn, Branko; Bokal-Vrtačnik, Eda; Ribič-Pucelj, Martina; Vogler, Andrej; Drobnič, Sašo; Pinter, Bojana; Bačer-Kermavner, Lili; Valentinčič-Gruden, Brigita; Veble, Alenka; Mivšek, Jožica; Verdenik, Ivan
Title     Program zunajtelesne oploditve na Ginekološki kliniki v Ljubljani
Translated title     Programme of in vitro fertilization at the Department of obstetrics and gynecology in Ljubljana
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 70, št. 2
Publication year     2001
Volume     str. 89-95
ISSN     1318-0347
Language     slo
Abstract     Background. In 1983 the programme of in vitro fertilization and embryo transfer (IVF-ET) was introduced at the Division of Human Reproduction, Department of Obstetrics and Gynecology in Ljubljana. The IVF-ET procedure is one of infertility treatment modalities, which has witnessed an unexpectedly great progress in the last decade. Methods. For various male and female factors of infertility 14.216 IVF-ET cycles were performed between 1984 and 1999. We compared the pregnancy rates achieved in various indications for infertility treatment as well as in various types of ovarian stimulation protocols. The evaluation of clinical results of IVF-ET was also made between the period when up to 4 embryos were transferred and the period when up to 2 embryos were transferred. Besides, we compared the clinical results obtained by intracytoplasmic sperm injection (ICSI) with those obtained by the standard IVF-ET procedure. Additionally, we analysed the effect of developmental stage of frozen/thawed embryos on the pregnancy rate. Results. With IVF-ET procedure 2281 pregnancies were achieved resulting in deliveries of 1825 babies. With regard to indications the best results were achieved with endocrine causes of infertility (29% pregnancy rate/ET) and the worst with male infertility (19% pregnancy rate/ET). Considering the type of ovarian stimulation, the best results were achieved with human menopausal gonadotropins (HMG) combined with gonadotropin-releasing hormone analogues (GnRH-a) (21.9% pregnancy rate/ET). The comparison of growth hormone (GH) co-treated cycles (n=135) vs. non co-treated cycles (n=697) showed a significantly higher number of retrieved and fertilized oocytes in the GH co-treated cycles. (Abstract truncated at 2000 characters.)
Summary     Izhodišča. Na Kliničnem oddelku Reprodukcija Ginekološke klinike v Ljubljani smo uvedli program zunajtelesne oploditve in prenosa zarodka (IVF-ET) leta 1983. Tovrstna oblika zdravljenja neplodnosti je v zadnjem desetletju doživela nepričakovano velik razvoj. Metode. Zaradi različnih ženskih in moških vzrokov neplodnosti smo v obdobju od 1984 do 1999 opravili 14.216 ciklusov IVF-et. Primerjali smo stopnjo nosečnosti pri različnih indikacijah za uvedbo postopka in pri različnih načinih hormonskega vzpodbujanja jajčnikov. Ocenjevali smo klinične rezultate IVF-ET iz obdobja, ko smo v maternico prinesli največ 4 zarodke, s tistimi iz obdobja, ko smo prinesli največ 2 zarodka. Primerjali smo klinične rezultate postopka neposrednega vnosa semenčice v citoplazmo jajčne celice (ICSI) s kliničnimi rezultati, ki smo jih dobili s klasičnim postopkom zunajtelesne oploditve (IVF-ET). Preučevali smo tudi vpliv razvojne stopnje odmrznjenih zarodkov na stopnjo nosečnosti. Rezultati. S postopkom IVF-ET smo dosegli 2281 nosečnosti, rodilo se je 1825 otrok. Glede na indikacije so bili doseženi najboljši rezultati pri hormonskih vzrokih neplodnosti (29% nosečnosti/ET), najslabši rezultati pa so bili pri moški neplodnosti (19% nosečnosti/ET). Pri upoštevanju načina spodbujanja jajčnikov smo najboljše rezultate zdravljenja dosegli z uporabo kombinacije HMG in GnRH-analogov (21,9% nosečnosti/ET). Primerjava rezultatov zdravljenja bolnic, ki so dodatno prejemale rastni hormon (RH-135 ciklusov), s tistimi brez RH (697 ciklusov) je pokazala pomembno večje število pridobljenih in oplojenih jajačnih celic ter prenesenih zarodkov v ciklusih z dodanim RH. IVF-ET v naravnem, nespodbujenem ciklusu je uspešen, preprost in cenejši postopek, ki za žensko predstavlja bistveno manjši psihofizični stres kot klasično spodbujanje jajčnikov s HMG. (Izvleček prekinjen pri 2000 znakih.)
Descriptors     FERTILIZATION IN VITRO
EMBRYO TRANSFER
EMBRYO
FREEZING
SPERMATOZOA