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Prophylactic cerclage in twin pregnancies from art: obstetric outcomes
Survival and development after ICSI of eggs from sequential donation cycles.
S. Hernandez, P. Dıaz, J. Sepulveda. Reproductive Biology, Instituto para elEstudio de la Concepcion Humana (IECH), Monterrey, Nuevo Leon, Mexico.
OBJECTIVE: To compare the obstetric outcomes of twin pregnancies af-
ter ART with and without prophylactic cerclage (McDonald technique).
MATERIALS AND METHODS: A total of 129 patients were included, all
of them carrying a twin pregnancy resulted from ART between years 2007-
2010. Prophylactic cerclage was performed in 46 while the remaining 83served as controls. The decision about performing or not the cerclage wastaken randomly by each attending physicians and all the patients were fol-
Data presented as mean Æ S.E.M. An ¼ 97, Bn ¼ 75, Cn ¼ 13. No statistical
differences were observed between 1st, 2nd and 3rd donations for any of the
RESULTS: All the demographic characteristics between groups (cerclage
variables (P%0.05). * Some data points for implantation rate are pending and
and no cerclage) were comparable: age (33.1 Æ 5.4 vs 33.8 Æ 5.21), weight
were omitted. nimp.1 ¼ 90, nimp.2 ¼ 71, nimp.3 ¼ 11.
(68.1 Æ 13.7 vs 67.5 Æ 12.32kg), height (1.59 Æ .066 vs 1.56 Æ .077mts),
CONCLUSION: Results imply that sequential donations have no signifi-
BMI (26.4 Æ 5.00 vs 23.0 Æ 1.94), FSH day 3 (7.6 Æ 6.04 vs 10.49 Æ
cant negative effect on egg quality, survivability or developmental potential.
12.2 IU), LH day 3 (4.03 Æ 2.94 vs 5.81 Æ 5.23 IU), E2 day 3 (57.6 Æ
Donors with successful first cycles can thus be encouraged to return for sub-
47.9 vs 57.07 Æ 60.6 pg/dL) and PRL (17.46 Æ 7.60 vs 16.96 Æ 12.32 ng/
sequent donations. Results may be valuable to potential donors concerned
ml). Similarly there were no differences in day of retrieval (12.67 Æ
about the effects of egg donation on subsequent fertility. Research on natural
.93vs12.59 Æ 6.11), aspirated oocytes (12.83 Æ 5.3vs11.70 Æ 7.23), MII oo-
reproductive performance of egg donors later in life will be valuable to give
cytes (10.32 Æ 5.30vs9.77 Æ 6.73), injected/inseminated (10.86 Æ
5.43vs9.65 Æ 5.79), fertilization rate (64%vs74%), day of transfer (2.96 Æ0.81vs2.95 Æ 0.72), embryos transferred (2.87 Æ 0.65vs3.02 Æ 0.62). Amongthe obstetric variables, a significant difference was observed in gestational
weeks (35.65 Æ 1.96 vs. 33.79 Æ 5.28,P<0.05), average weight (2358.8 Æ462.73 vs.2103.90 Æ 711.78, P<0.05).
ADD ONS FOR IN VITRO FERTILISATON (IVF). AN ACT OF DES-
CONCLUSION: Patients with twin pregnancy and prophylactic cerclage
PERATION? B. Vollenhoven, T. Osianlis, N. Hope, C. Motteram,
had a better gestational age and better birth weight compared to those without
L. Rombauts. Monash IVF, Melbourne, VIC, Austria; Obstetrics and Gynae-
cerclage. Prophylactic cervical cerclage should be considered as routine in
cology, Monash University, Melbourne, VIC, Australia; Gynaecology,
Southern Health, Melbourne, VIC, Australia.
OBJECTIVE: Using a large retrospective case-control study we sought to
investigate the effectiveness of a combined co-treatment with aspirin, doxycy-
INCIDENCE OF CONGENITAL ANOMALIES IN 2351 IVF/ICSI
cline, prednisolone Æ luteal phase estradiol patches (treatment) on average
number of oocytes collected (O), fertilisation (FR), clinical pregnancy (PR)
P. E. Levi Setti, A. Baggiani, S. Castelli, G. Bracone, A. Marras,
and live birth (LBR) rates in fresh and frozen IVF/microinjection (ICSI) cycles.
E. Albani. Department of Gynecology, Operative Unit of Gynecology and
DESIGN: A 1:1 matched case control study at Monash IVF from 2005-2008.
Reproductive Medicine, IRCCS Istituto Clinico Humanitas, Rozzano,
MATERIALS AND METHODS: The total number of cycles was 970 with
324 fresh cycles pairs and 161 frozen cycle pairs. Cycles were matched for
OBJECTIVE: Follow up of babies born from infertile couples enrolled in
number of embryos transferred (ET), day of transfer, insemination method, pa-
an ART program is a major clinical effort and a quality assurance standard for
tient age, stimulation cycle number. 254 patients had aspirin, doxycycline and
National and International Registers. Aim of the present study is to present
prednisolone and 231 had the same drugs with estradiol. Data were analysed
the incidence of congenital anomalies of babies born after transfer of fresh
using Chi-square tests for categorical variables and independent samples
IVF/ICI embryos in an infertile population.
and t-test for comparison of group means. Data are presented as frequency
DESIGN: Retrospective study was performed from 1996 to may 2009.
(%) and mean ( Æ SD). P <0.05 was considered statistically significant.
MATERIALS AND METHODS: All pregnancies obtained after the trans-
RESULTS: We found no difference in O, PR or LBR when co-treatments
fer of fresh embryos were followed by a group of clinical psychologist at least
with or without estradiol were investigated separately, hence the grouping of
at the conclusion of the prenatal period and every 6 months after delivery. All
the treatments. There was also no difference in outcomes between treatment
pregnancies R 24 weeks of gestational age were considered in the study.
and control groups in IVF or ICSI cycles. As shows, there was a det-
Eurocat (European Surveillance of Congenital Anomalies) classification
rimental affect on LBR for frozen cycles when co-treatments were used.
was applied to identify congenital anomalies.
RESULTS: 1867 deliveries were recorded, 1424 (76.4%) single pregnan-
cies, 398 (21.3%) twins and 43 (2.3%) triplets. Female age at the beginning ofinduction was 35.4 years Æ 4.1 years. A total 2351 babies were delivered,
1137 males (48.4%) and 1214 females (51.6%).
TABLE I. Congenital anomalies incidence after ART cycles with fresh embryo
When the matched pairs were examined according to number of stimulated
cycles (SC) 1 or 2 compared with R3, the implantation rate was lower in the
treatment group SC1or2 (21.4%) compared with 30.1% in control (P¼0.03).
Miscarriage rates were significantly higher (P¼0.02) in the SCR3 treatment
CONCLUSION: This matched case-control study does not provide sup-
port for the continued use of these addjuvants in IVF patients.
PROPHYLACTIC CERCLAGE IN TWIN PREGNANCIES FROM
ART: OBSTETRIC OUTCOMES. E. A. Galindo, P. Galache, I. Obeso,
* 2 congenital deafness, 1 mastocytoma right hand.
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