Usporedba ishoda spontano začetih blizanačkih trudnoća i blizanačkih trudnoća nakon postupka izvantjelesne oplodnje

master's thesis

• Title (english): Comparison of outcomes of spontaneously conceived twin pregnancies and twin pregnancies after in vitro fertilization
• Author: Eva Podolski
• Mentor: Ivan Bolanča (mentor)
• Committee member: Marina Šprem-Goldštajn (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Ivan Bolanča (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

U zadnjih par desetljeća medicinski pomognuta oplodnja (MPO), u koju spada i postupak izvantjelesne oplodnje (IVF), značajno se razvila. Zahvaljujući tome, uspjeli su se smanjiti rizici i nepoželjni ishodi postupaka MPO-a. S obzirom da su blizanačke trudnoće rizičnije od jednoplodnih, provedena su mnoga istraživanja u kojima su se razmatrali njihovi ishodi i rizici. Unatoč mnogim oprečnostima i razlikama u provedenim studijama koje su uspoređivale ishode spontano začetih blizanačkih trudnoća i blizanačkih trudnoća iz postupka IVF-a, sve studije pokazale su da postupak IVF-a dodatno povećava rizik od prijevremenog poroda, a time i broj hospitalizacija na novorođenačkom odjelu intenzivne njege. U današnje vrijeme blizanačka trudnoća iz postupka MPO-a može se izbjeći, a u tu svrhu Europsko društvo za humanu reprodukciju i embriologiju izdalo je nove preporuke za specijaliste humane reprodukcije. Navedene preporuke nastale su na temelju usporedbe mogućih koristi i rizika izbornog prijenosa jednog i dva embrija s obzirom na psihosocijalne, financijske i kliničke čimbenike pacijentica, te regulatornih okvira i politika naknada u europskim državama u kojima se izvodi MPO. Nakon uzimanja svih čimbenika u obzir, smjernice preporučuju izborni prijenos jednog umjesto više embrija, što smanjuje mogućnost za blizanačku trudnoću kao ishod MPO-a, a time i izbjegavanje komplikacija koje nose blizanačke trudnoće.

Abstract (english)

Over the past few decades, assisted reproductive techniques (ART), including the process of in vitro fertilization (IVF), has significantly developed. Thanks to these advancements, the risks and undesirable outcomes of the procedure have been reduced. Twin pregnancy, being one of them, is inherently more risky than singleton pregnancy, and it has long been debated whether the process of in vitro fertilization makes it even riskier. Despite many contradictions and differences between studies comparing the outcomes of spontaneously conceived twin pregnancies and twin pregnancies from in vitro fertilization, all have shown that the in vitro fertilization process only further increases the risk of preterm birth, and consequently the number of hospitalizations in the neonatal intensive care unit. Nowadays, twin pregnancies from ART can be avoided, and for this purpose, the European Society of Human Reproduction and Embryology (ESHRE) has issued new recommendations for specialists in human reproduction. These recommendations compare all possible benefits and disadvantages of elective single embryo transfer (eSET) and double embryo transfer (DET) considering the psychosocial, financial, and clinical factors of the patients, as well as the policy and rights of the country in which the MAR is performed. The guideline's recommendation is, after taking all factors into account, a single elective embryo transfer (eSET) instead of multiple ones, which reduces the chance of twin pregnancy as an outcome of ART and avoids the complications associated with twin pregnancies.

• Keywords: blizanačka trudnoća; izvantjelesna oplodnja; prijenos jednog izbornog embrija
• Keywords (english): twin pregnancy; in vitro fertilization; elective single embryo transfer
• Language: croatian
• URN:NBN: urn:nbn:hr:105:684115
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-06-22 07:10:02