Blastocyst Culture and Transfer Maintain Pregnancy Rate but Reduce the Risk of a High Order Multiple Gestation

BACKGROUND: In recent times, the incidence of multiple pregnancies has significantly increased dueto medication for induced ovulation and other reproductive technologies. The present study is designedto see the maternal complication of multiple gestations in pregnancy.OBJECTIVE: To determine the maternal complications associated with multiple gestation in secondand third trimester of pregnancy.METHODOLOGY: This descriptive study was carried out in the department of obstetrics andGynaecology unit at Lady Reading Hospital Peshawar. Duration of the study was 06 months from 1stJanuary 2012 to 1st July 2012. All patients with twin gestations, triplets and high order multiples visitingobstetrics and Gynaecology unit at Lady Reading Hospital Peshawar and who were admitted in wardwere included in the study and after taking informed consent their characteristics were recorded byfilling proforma.RESULTS: Sixty patients with multiple gestations were included in the study. Fifty four (90%) of themhad twin pregnancy and 06 (10%) had triplet pregnancy. The antenatal complications detected in thesepatients were preterm labour 23(32.3%), anaemia 18(30%), pregnancy induced hypertension, preeclamptic toxaemia, eclampsia 13(21.7%), Malpresentation 13(21.7%), Antepartum Haemorrhage 5(8.3%), 5 patients (8.3%) had PROM, 4 (6.7%) had polyhydramnios, 3(5%) had miscarriages, 5 (8.3%)had postpartum haemorrhage, 44(73.3%) patients had spontaneous vaginal delivery and 15(25%)underwent caesarean section. In 28(46.7%) patients cephalic/cephalic was the most commonpresentation.CONCLUSION: Multiple gestation is a high risk pregnancy and is associated with both maternal andfetal complications. Patient needs to be educated about the importance and advantages of early antenatalbooking and regular antenatal follow-up to reduce the risks to the mother and the babies.KEY WORDS: Twin pregnancy, Triplets, High-order multiplets; Complications-Second Trimester,Third trimester.

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The elimination of Estradiol (E2) monitoring during controlled ovarian hyperstimulation (COH) with intrauterine insemination (IUI) will lead to acceptable pregnancy rates without an increase in high order multiple gestation or ovarian hyperstimulation syndrome (OHSS)

Fertility and Sterility ◽

10.1016/s0015-0282(03)01392-x ◽

2003 ◽

Vol 80 ◽

pp. 184

Author(s):

Carlos Rodriguez ◽

Estil Y. Strawn ◽

Deniz Karcaaltincabal ◽

Martha Reinke ◽

Phillip Lehman ◽

...

Keyword(s):

Ovarian Hyperstimulation Syndrome ◽

Intrauterine Insemination ◽

Controlled Ovarian Hyperstimulation ◽

Pregnancy Rates ◽

High Order ◽

Multiple Gestation ◽

Ovarian Hyperstimulation

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A study for evaluation of two protocols comprising of clomiphene citrate, human menopausal gonadotropin with or without follicle stimulating hormone for ovulation induction in patients with infertility for intrauterine insemination

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20192455 ◽

2019 ◽

Vol 8 (6) ◽

pp. 2487

Author(s):

Ashok Verma ◽

Shivani Sharma ◽

Suresh Verma ◽

Pankaj Sharma ◽

Tenzin Tsamo Tenga ◽

...

Keyword(s):

Menstrual Cycle ◽

Pregnancy Rate ◽

Ovulation Induction ◽

Endometrial Thickness ◽

Intrauterine Insemination ◽

Clomiphene Citrate ◽

Human Menopausal Gonadotropin ◽

Multiple Gestation ◽

Group A ◽

Group B

Background: To compare two protocols comprising of FSH/CC/HMG and CC/HMG for ovulation induction and IUI in women with infertility.Methods: 60 women with unexplained infertility were randomized using sequentially numbered opaque envelope method. Group A received inj FSH 150 units on day 2 of menstrual cycle and clomiphene citrate 100 mg from day 3-7, followed by injection HMG 150 units on day 9 of menstrual cycle. Group B received clomiphene citrate 100 mg from day 3-7, and HMG 150 units on day 7 and 9 of the menstrual cycle. Ovulation triggered with hCG 5000 units when dominant follicle was 18mm. Single IUI was done 36-42 hours afterwards.Results: Pregnancy occurred in 3 out of 30 women in 116 cycles Group A (with FSH) with a pregnancy rate of 10 percent, and 2.8% per cycle. In group B (without FSH) pregnancy occurred in 3 out of 30 women in 117 cycles with pregnancy rate of 10 percent, and 2.6% per cycle. The number of follicles per cycle was 1.36 and follicle size was 18.57 mm in group A. While in Group B numbers of follicles per cycle were 1.22, with average size of 18.9mm. Mean endometrial thickness was 7.7mm in Group A and 6.37 in Group B (p=.01, significant). Mild OHSS was observed in one woman in Group B. No other side effects were observed in both the groups.Conclusions: The controlled ovarian stimulation regimes used in this study are equally effective, easy to administer, require less intensive monitoring and fewer medications, with little risk of OHSS and multiple gestation.

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