Biomedical subjects

Kathelijne Mangelschots

Publications and source records attributed to Kathelijne Mangelschots.

3 recordsLinked to original sources

PubMed2005

Impact of a restriction in the number of embryos transferred on the multiple pregnancy rate.

OBJECTIVE: To study the impact of the introduction of reimbursement of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) laboratory costs in Belgium which is linked to an embryo transfer strategy leading to prevention of multiple pregnancies. The impact on the incidence of multiple and twin pregnancy rate as well as on ongoing pregnancy rate in our centre is calculated. STUDY DESIGN: Observational cohort study of all patients in the first year (July 1, 2003-June 30, 2004) since the implementation of the law and comparison of ongoing pregnancy rate and multiple pregnancy rate of our centre with Belgian data. RESULTS: Our results of one year of IVF/ICSI since reimbursement of laboratory costs show a total conception rate of 42.2% with 29.7% ongoing pregnancies beyond 25 weeks amenorrhea. The multiple pregnancy rate was 8.5% including five monozygotic twin pregnancies. These data show an important decline of multiple pregnancy rate when compared to Belgian data (2002) with 24.4% multiple pregnancy rate in the year prior to reimbursement. CONCLUSION: The introduction of reimbursement of IVF/ICSI laboratory costs coupled to a restriction in the number of embryos for transfer has reached the goal of halving the multiple pregnancy rate since its introduction while maintaining an optimal ongoing pregnancy rate.

Adult↗

PubMed2004

Singleton pregnancies are as affected by ovarian hyperstimulation syndrome as twin pregnancies.

The incidence of ovarian hyperstimulation syndrome (OHSS) did not decrease during the 5 years in which single-embryo transfer was introduced; OHSS is not more frequent in twin than in singleton pregnancies.

Embryo Transfer↗

PubMed2003

Multinucleation in cleavage stage embryos.

BACKGROUND: The aim was to analyse multinucleation in relation to its incidence in time and in the population, and its correlation with clinical variables, with other morphological characteristics and with the implantation rate of cleavage stage embryos. METHODS: Retrospective analysis of 10 388 cleaved embryos from 1395 consecutive IVF/ICSI cycles in 700 patients between January 1, 1999 and June 30, 2002. RESULTS: Multinucleation was observed in 3491 (33.6%) embryos in 1107 cycles (79.4%) of 609 (87%) patients, more frequently on day 2 than on day 3: 2848 (27.4%) versus 1567 (15.1%) [relative risk (RR) = 1.82; 95% confidence interval (CI) = 1.72-1.92]. Its incidence increased with fragmentation: 31.0, 34.4 and 36.5% for fragmentation </=10%, 10-20% or 20-30%. It was increased in stimulation cycles that were shorter (34.9 versus 32.0%, RR = 1.09; 95% CI = 1.03-1.15), required a higher FSH dose (34.6 versus 32.0%, RR = 1.08; 95% CI = 1.02-1.14) and yielded more oocytes (34.5 versus 29.7%, RR = 1.16; 95% CI = 1.08-1.25). Four-cell embryos on day 2 showed minimal multinucleation (16.8%) as well as 8-cell embryos on day 3 (15.5%). Embryos counting both 4 blastomeres on day 2 and 8 on day 3 showed minimal multi nucleation (11.6%). Multinucleated embryos had a decreased implantation rate: 4.3% in single and 5.7% in double embryo transfers. CONCLUSIONS: Multinucleation is a frequently observed phenomenon. It is associated with impaired cleavage and increased fragmentation and is compromising the ongoing implantation rate. Multinucleation should be part of embryo assessment.

Adult↗