Author/Editor		Bačer-Kermavner, Lili; Virant-Klun, Irma; Valentinčič-Gruden, Brigita; Kmecl, Jerneja; Mivšek, Jožica; Tomaževič, Tomaž; Ribič-Pucelj, Martina; Vogler, Andrej; Bokal-Vrtačnik, Eda; Zorn, Branko; Drobnič, Sašo; Pinter, Bojana; Meden-Vrtovec, Helena
Title		Dvoplodna nosečnost po prenosu dveh zarodkov
Translated title		Twin pregnancy after the transfer of two embryos
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. Suppl 2
Publication year		2003
Volume		str. II-69-72
Language		slo
Abstract		Background. Twin pregnancy rates following the transfer of two embryos in in vitro fertilization (NF) treatment are high. Therefore, the aim of this study was to evaluate twin pregnancy rates in regard to the developmental stage of the embryo, patient age, and cause of infertility. Methods. A retrospective analysis involved 1222 NF procedures. Overall pregnancy rates and twin pregnancy rates following the transfer of two blastocysts or two cleavage-stage embryos were assessed. The blastocyst group was divided into four age subgroups, and into four subgroups by the cause of infertility. Results. After the transfer of two blastocysts or two cleavagestage embryos the overall pregnancy rates (45% vs. 9%) and the twin pregnancy rates (18% vs. 5%) were significantly higher in the blastocyst group. The effects of patient age and the transfer of two blastocysts on the overall pregnancy and twin pregnancy rates were significantly greater in the subgroups of patients aged <- 30 years (21%) and 31-34 years (20%) than in older patients (35-38 years = 15.7%; >= 39 years = 9%). In the blastocystgroup the twin pregnancy rate was significantly higher in patients with tubal (21%) and endocrinological causes of infertility (24.5%) than in patients with endometriosis (7%) and uterine malformations (12.5%). Conclusions. After the transfer of two blastocysts twin pregnancy rates are significantly higher in patients with tubal factor or endocrinological causes of infertility younger than 34 years. In this population of women the risk of twin pregnancy can be avoided by the transfer of a single embryo most developed blastocyst.
Summary		Izhodišča. Delež dvoplodnih nosečnosti po prenosu dveh zarodkov v postopkih OBMP je visok, zato je bil naš namen ugotoviti delež dvoplodnih nosečnosti v odvisnosti od razvojne stopnje zarodka, starosti bolnic in vzrokih neplodnosti. Metode. Retrospektivno smo analizirali 1222 postopkov oploditve z biomedicinsko pomočjo (OBMP). Ugotavljali smo stopnjo nosečnosti in delež dvoplodnih nosečnosti po prenosu dveh blastocist ali dveh manj razvitih zarodkov v maternico. Skupino s prenosom dveh blastocist smo razdelili v štiri starostne skupine, prav tako pa tudi v štiri skupine po vzrokih neplodnosti. Rezultati. Po prenosu dveh zarodkov je bila stopnja zanositve po prenosu dveh blastocist statistično značilno višja kot po prenosu dveh manj razvitih zarodkov (45% vs. 9%), od tega je bilo dvoplodnih nosečnosti satistično značilno več po prenosu dveh blastocist kot po prenosu dveh manj razvitih zarodkov (18% vs. 5%). Vpliv starosti bolnic in prenos dveh blastocist na stopnjo zanositve in delež dvoplodnih nosečnosti je pri skupini <= 30 let (21%) in 31-34 let (20%) statistično značilno večji kot pri skupini starejših bolnic (35-381et = 15,7%; 39 let in več = 9%). Pri prenosu dveh blastocist je bil delež dvoplodnih nosečnosti pri bolnicah z nepravilnostmi jajcevodov (22%) in z endokrinološkimi vzroki neplodnosti (24,5%) statistično značilno večji kotpri endometriozi (7%) in nepravilnostih maternice (12,5%). Zaključki. Po prenosu dveh blastocist je delež dvoplodnih nosečnosti statistično značilno višji pri bolnicah z nepravilnostmi jajcevodov in endokrinološkim vzrokom neplodnosti in mlajših od 34 let. Pri vseh teh bolnicah bi se tveganju za dvoplodno nosečnost lahko izognili sprenosom enega samega zarodka - najrazvitejše blastociste.
Descriptors		PREGNANCY, MULTIPLE FERTILIZATION IN VITRO EMBRYO TRANSFER TWINS PREGNANCY INFERTILITY, FEMALE BLASTOCYST