Author/Editor		Kovačič, Borut; Čižek-Sajko, Mojca; Vlaisavljević, Veljko
Title		Kakovost blastocist in vitro in večplodna nosečnost
Translated title		Quality of blastocyst in vitro and multiple pregnancies
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. Suppl 2
Publication year		2003
Volume		str. II-89-92
Language		slo
Abstract		Background. The blastocysts, obtained from in vitro fertilization, have different morphologic characteristics. The aim of the study is to investigate the effect of morphology of transferred blastocysts on pregnancy and multiple pregnancy rate. Methods. The quality of blastocysts was evaluated by four parameters: amount of embryo mass transformed into the blastocyst, blastocoel expansion, shape of inner cell mass and proliferation of trophectoderm cells. In the first group the blastocysts with four optimal parameters were arranged. The second group was formed from blastocysts with one nonoptimal parameter and the third group from blastocysts with more nonoptimal parameters. The results of 175 transfers of two blastocysts from first group, 65 transfers of two blastocysts from second and 20 transfers of two blastocysts from third group were analysed retrospectively. Results. Implantation rate was the highest in the first group of transfers and differed significantly in comparison to second and third group (54.7% vs. 31.5% vs. 7.5%; p < 0.05). Most pregnancies were achieved after the transfer of two optimal blastocysts in comparison to other groups of transfers (62.3% vs. 40% vs. 15%; p < 0.05). Multiple pregnancy rate was 56.9% in the first group, 23% in the second group, while in the third group of transfers there was no multiple pregnancy. Conclusions. By selecting the blastocysts for transfer into the uterus it is advantageous that blastocsyt morphology characteristics are taken into the consideration. Using our blastocyst scoring system it is possible to select out the high quality blastocysts. The probability of implantation by them is more than 50%, for that reason only one such blastocyst could be transferred without any effect on pregnancy rate.
Summary		Izhodišča. Blastociste, ki jih dobimo vpostopku oploditve z biomedicinsko pomočjo (OBMP), imajo različne morfološke značilnosti. Namen raziskave je ugotoviti, kako morfologija blastocist, prenesenih v maternico, vpliva na zanositev in večplodno zanositev. Metode. Kakovost blastocist smo ocenjevali s štirimi parametri: deležem zarodka, preoblikovanega v blastocisto, razširjenostjo blastocela, obliko notranje skupine celic in z razrastjo celic trofektoderma. V prvo skupino smo uvrstili blastociste, ki so imele optimalne vse parametre, v drugo skupino blastociste z enim neoptimalnim parametrom in v tretjo skupino blastociste z več neoptimalnimi parametri. Retrospektivno smo analizirali rezultate 175 prenosov dveh blastocist iz prve skupine, 65 prenosov dveh blastocist iz druge skupine in 20 prenosov dveh blastocist iz tretje skupine. Rezultati. Delež blastocist, ki so se ugnezdile v maternici, je bil najvišji v prvi skupini in se je statistično značilno razlikoval v primerjavi z drugo in tretjo skupino (54, 7% oz. 31,5% oz. 7,5%; p < 0, 05). Po prenosu dveh optimalnih blastocist smo v primerjavi z ostalima skupinama dosegli največ zanositev (62,3% oz 40% oz. 15%; p < 0,05). Delež večplodnih nosečnosti je bil v prvi skupini 56,9%, v drugi 23%, v tretji skupini pa večplodne nosečnosti ni bilo. Zaključki. Pri izboru blastocist za prenos v maternico je koristno upoštevati njihove morfološke značilnosti. Z našo ocenjevalno lestvico je možno izbrati blastociste z najvišjo kakovostjo. Ker je pri njih verjetnost ugnezditve več kot 50% lahko brez tveganja vrnemo samo eno takšno blastocisto in se izognemo večplodnim nosečnostim.
Descriptors		BLASTOCYST FERTILIZATION IN VITRO PREGNANCY, MULTIPLE PREGNANCY EMBRYO TRANSFER