Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Multiple gestation pregnancy
Autore:
Crosignani, PG; Rubin, BL;
Indirizzi:
Univ Milan, Fac Med & Chirurg, Clin Ostet & Ginecol 1, I-20122 Milan, Italy Univ Milan Milan Italy I-20122 n Ostet & Ginecol 1, I-20122 Milan, Italy
Titolo Testata:
HUMAN REPRODUCTION
fascicolo: 8, volume: 15, anno: 2000,
pagine: 1856 - 1864
SICI:
0268-1161(200008)15:8<1856:MGP>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
IN-VITRO FERTILIZATION; DIZYGOTIC TWINS; INTRAUTERINE INSEMINATION; OVARIAN STIMULATION; EMBRYO REDUCTION; UNITED-STATES; BIRTH-WEIGHT; MOTHERS; COST; SINGLETONS;
Keywords:
assisted reproduction; embryo transfer; multiple pregnancy; ovarian stimulation; pregnancy rates;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
58
Recensione:
Indirizzi per estratti:
Indirizzo: Crosignani, PG Univ Milan, Fac Med & Chirurg, Clin Ostet & Ginecol 1, Via Commenda 12, I-20122 Milan, Italy Univ Milan Via Commenda 12 Milan Italy I-20122 ilan, Italy
Citazione:
P.G. Crosignani e B.L. Rubin, "Multiple gestation pregnancy", HUM REPR, 15(8), 2000, pp. 1856-1864

Abstract

Multiple gestation pregnancy rates are high in assisted reproductive treatment cycles because of the perceived need to stimulate excess follicles andtransfer excess embryos in order to achieve reasonable pregnancy rates. Perinatal mortality rates are, however, 4-fold higher for twins and 6-fold higher for triplets than for singletons, Since the goal of infertility therapy is a healthy child, and multiple gestation puts that goal at risk, multiple pregnancy must be regarded as a serious complication of assisted reproductive treatment cycles. The 1999 ESHRE Capri Workshop addressed the psychological, medical, social and financial implications of multiple pregnancy and discussed how it might be prevented. Multiple gestations are high risk pregnancies which may be complicated by prematurity, low birthweight, pre-eclampsia, anaemia, postpartum haemorrhage, intrauterine growth restriction, neonatal morbidity and high neonatal and infant mortality. Multiple gestation children may suffer long-term consequences of perinatal complications, including cerebral palsy and learning disabilities. Even when the babies are healthy they must share their parents' attention and may experience slow language development and behavioural problems, Current data indicate that theaverage hospital cost per multiple gestation delivery is greater than the average cost of in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles. Prevention is the most important means of decreasing multiple gestation rates. Multiple gestation rates in ovulation induction and superovulation cycles can be reduced by using lower dosage gonadotrophinregimens. If there are more than three mature follicles, the cycle should be converted to an IVF cycle, or it should be cancelled and intercourse should be avoided. In IVF cycles two embryos can be transferred without reducing birth rates in most circumstances. Embryo reduction involves extremely difficult decisions for infertile couples and should be used only as a last resort. Assisted reproductive treatment centres and registries should express cycle results as the proportion of singleton live births; twin and triplet rates should be reported separately as complications of the procedures. Reducing the multiple gestation pregnancy rate should be a high priority for assisted reproductive treatment programmes, despite the pressure from some patients to transfer more embryos in order to improve success. If nothingis done, public concern may lead to legislation in many countries, a step that would be unnecessary if assisted reproductive treatment programmes andregistries took suitable steps to reduce multiple pregnancy rates.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/11/20 alle ore 18:08:26