Background. Spontaneous miscarriage isn’t an unexpected complication either in early spontaneous or in ART pregnancy. Previous studies showed that incidence of SM was slightly increased in ART ...pregnancies in comparison with spontaneous ones after adjusting for maternal age and previous SM. Our objective was to examine the relationship between SM and embryo quality after transfer of one or two blastocysts. Materials and methods. The total of 1433 stimulated IVF and ICSI cycles achieved in our center in the period from 2001 to 2002 after SBT or DBT were retrospectively analyzed. Of these, in the final analysis we included only cases with positive βhCG for which complete data on pregnancy outcome were available – 418 cycles in total. Results. The mean age of patients was 32.2 ± 4.5 years. IVF was performed in 133 cases and ICSI was performed in 285 cases, SBT in 69 and DBT in 349. After SBT, SM rate was 11.6 % and after DBT it was 12.0 %. In SBT group we didn’t find significant relationship between embryo quality and SM (logistic regression: c2 = 0.88; p > 0.05). In this groups, using standard statistical tests, we also couldn’t find significant difference in SM rate between subgroups where optimal or suboptimal quality blastocyst was transferred (Yates corrected c2 test: p > 0.05, Student’s t-test: p > 0.05). In DBT group, we found a strong relationship between embryo quality and SM (logistic regression: c2 = 10.12; p < 0.01). After standard analysis, we confirmed significant difference between subgroups with different combinations of blastocyst quality: after transfer of both optimal blastocysts SM rate was 8.5 %, after transfer of optimal and suboptimal blastocyst SM rate was 10.1 % and after transfer of both suboptimal blastocyst SM rate was 25.4 % (Kruskal-Wallis test: p < 0.001; one-way ANOVA: p < 0.001). We confirmed strong relationship between age of the patients and SM (logistic regression: c2 = 14.57; p < 0.0001). Conclusions. In our study SM rate was 11.9 % which was lower than in previous reports; it was even at the lower limit of expected SM rate in general population. This discrepancy was probably the consequence of longer selection period of blastocysts in in vitro conditions. We didn’t find a significant relationship between SM and blastocyst quality after SBT, which was probably due to the small sample size. A strong relationship between SM and blastocyst quality after DBT was proved. We also confirmed a strong relationship between age of the patients and SM.
Background: Slovenian perinatal results are compared with European results: sometimes they are in the higher, sometimes in the lower range. Analysing trends and comparisons with other countries helps ...in planning changes in organisation and function so we are prepared for future challenges. Introduction of new technologies demands appropriate answers to challenges, including ethical ones. Methods: We compared perinatal results in Slovenia from 1987 to 1996, the PERISTAT project results from the year 2000 and the EURO-PERISTAT project with 2004 perinatal results including the Slovenian. Results: Some of the more prominent Slovenian perinatal results are shown. Cesarean section rate is the lowest among 26 countries in Europe. Deliveries after artificial reproductive techniques are second most frequent. Teenage pregnancies are very rare. Seemingly high maternal mortality mirrors also strict recording and cross checking with other data bases. Relatively high stillbirth rate may reflect the fact that all induced labours for fetal malformations are recorded. Conclusions: In Slovenia we do have tools for quality collection of perinatal results which should be used and audited. To have comparable results inside Slovenia, definitions should be written at http://www.obgyn-si.org/. When changing delivery record markers of prenatal care should be added – they could be easily obtained from maternity booklets (electronic or paper). In maternity booklet there is a place to write about grand dad prostate cancer; let us replace it with risk factors for preterm delivery (medical history and cervical length), 12 weeks screening for preeclampsia and intrauterine growth restriction (ultrasonic and biochemi- cal markers), gestational diabetes and obesity (body mass index, waist – hips ratio) and hypothyroidism; let us leave some free space for the future screening tests. Known and proven efficient management (e.g. progesterone for recurrent preterm delivery prevention) should be used.
