Payment is being processed by. Please wait while the order is being comfirmed. This site uses cookies. Play 0 0 0. What do you think of this song? Forgot Password? Get Code. Male Female. I have read and accept Terms and Conditions. Order Date. Due Today. Now you have access to all the features of Boomplay App. In both singleton and twin pregnancies, the incidence of abortion increased with age.

Human reproduction is a remarkably inefficient process with a high risk of early fetal wastage. Wilcox et al. Urinary concentrations of hCG were measured for a total of menstrual cycles.

Using a threshold level of 2. Numerous causes for this low rate of viable conceptuses can be suggested. It is thought that intrinsic abnormalities within the embryo are the major reason for failed conceptions or early fetal death. Trisomies 13, 15, 16, 18 and 21 account for the most common autosomal trisomies in spontaneous pregnancy losses Racowsky, It may be that in the future preimplantation genetic screening of embryos prior to transfer may reduce early pregnancy wastage resulting from aneuploidy Handyside et al.

In assisted reproduction technology, inappropriate culture conditions may considerably impair human embryonic development in vitro and implantation potential, and it is thought that the improvement in pregnancy rates after assisted reproduction treatment during the last 10 years mainly is the result of improving culture conditions.

Different embryo characteristics fragmentation of the embryo, presence or absence of any irregular blastomeres, speed of cleavage, etc. Therefore, a better knowledge of embryo characteristics could have a large influence on future embryo transfer policies, and not only improve pregnancy rates but also decrease early pregnancy loss rates. Following assisted reproduction treatment, the risk of miscarriage may seem a bit higher than in spontaneous pregnancies, but this is thought to be due to earlier pregnancy detection on the one hand, and to older maternal age on the other.

Although the absolute figures obtained in our study cannot be transposed to spontaneous pregnancies, it may be assumed that the relative risk of abortion in relation to the detection of fetal heart activity and the duration of gestation can be extrapolated to spontaneous pregnancies.

Many authors Abdalla et al. This is also confirmed by our own data. The outcome in terms of survival of twin pregnancies appears to be better than that of singleton pregnancies.

Although women with twin pregnancies were somewhat younger than those with a singleton pregnancy, this difference cannot be explained by differences in age. Indeed, when we compare miscarriage rates between singletons and twins in different age groups, the differences between singletons and twins remained in all age groups.

In assisted reproduction treatment cycles, it still is a widespread habit to transfer more than one embryo, in order to maximize the chance of a pregnancy. This practice results in a high rate of multiple pregnancies. The incidence of multiple pregnancies after IVF does not, however, follow a binomial probability curve. Twinning rates are much higher than expected. This means that embryos do not implant in an independent way, which is also demonstrated by the results obtained with single embryo transfer SET.

However, all pregnancies in the present study are the result of a strategy of double embryo transfer and no elective SET pregnancies were included in our data we only introduced SET in our centre in in a systematic way and on a large scale Coetsier and Dhont, ; De Sutter et al. The observation that miscarriage rates per fetal sac are lower in twin than in singleton pregnancies therefore may suggest that embryos in twin pregnancies have a better intrinsic potential than in singleton pregnancies.

It would seem that these embryos are part of a better cohort of embryos, not only possessing a higher implantation potential, but also a higher potential for successful further development. When the complete pregnancy loss in twins 5. It is clear that the chance of complete pregnancy loss is more than twice as large in the singleton group when compared with the twin group. This means that the embryological potential for successful development is not the same in both groups.

This is congruent with data comparing the outcome of IVF singleton and twin pregnancies with that of spontaneous singleton and twin pregnancies Dhont et al. Because the decision whether a pregnancy was a singleton or a twin could only be made at the moment of the first ultrasound, it can be assumed that a fraction of these singletons were in fact early vanishing twins.

This early pregnancy loss might have contributed to further pregnancy loss later on after the first ultrasound. Keeping in mind that multiple pregnancies are associated with a significantly higher risk of complications for both mother and child than singleton pregnancies, and given the economic consequences of twin pregnancies for society ESHRE Capri Workshop Group, ; Olivennes, , the results of this study should not be interpreted as a plea for twin pregnancies and double embryo transfer.

On the contrary, this study provides additional proof that SET is a logical strategy to consider Vilska et al. Indeed, in pregnancies occurring after SET, the embryo which was selected for transfer would have implanted if a double embryo transfer had been performed. This implies that this single embryo leading to pregnancy after SET has the same developmental potential as when it would have been part of a twin pregnancy following a double transfer.

It will be very interesting to extend this study in the future to all SET pregnancies, and it is to be expected that the miscarriage rates in SET pregnancies will be as low as those reported for the twins in the present study. In conclusion, after fetal heart activity is established, the risk of abortion in IVF pregnancies is halved. The potential for survival is significantly higher in twin pregnancies at all stages of the first trimester, pointing to a cohort phenomenon.

Figure 1. Risk of spontaneous abortion per fetal sac in relation to gestational age comparison of twin pregnancies versus singleton pregnancies. Total risk of spontaneous abortion per fetal sac in relation to maternal age. Abdalla, H. Andersen, N. Coetsier, T. DJ Zero. Share Download. You must be logged in to comment.

 
 

 

Twin of twins vol 10 download. Twin of Twins

 

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