ABSTRACT
La utilización de técnicas de reproducción asistida (TRA) ha aumentado en todo el mundo, incluyendo procedimientos como la donación de gametos, la subrogación y el diagnóstico genético preimplantacional. Creciente evidencia confirma que los embarazos de pacientes sometidas a estos tratamientos tienen un mayor riesgo de complicaciones perinatales. No queda claro si la causa de estos hallazgos se debe a la infertilidad subyacente o los tratamientos en sí. Esta revisión tiene como objetivo resumir la evidencia actual acerca de los efectos sobre los resultados maternos y perinatales tanto de los diferentes procedimientos propios de la fecundación in vitro como de algunos tipos de TRA especiales.
The use of assisted reproduction techniques (ART) has increased worldwide, including procedures such as gamete donation, subrogation and preimplantation genetic diagnosis. Growing evidence confirms that pregnancies following these treatments have an increased risk of adverse perinatal outcomes. It is not clear whether the cause of these findings is due to the underlying infertility or the treatments themselves. This review aims to summarize the current evidence regarding the effects of both the different ART procedures and some special types of ART on maternal and perinatal outcomes.
Subject(s)
Humans , Female , Pregnancy , Reproductive Techniques, Assisted/adverse effects , Ovulation Induction/adverse effects , Infant, Low Birth Weight , Pregnancy Outcome , Fertilization in Vitro/adverse effects , Risk , Premature Birth/etiology , Embryo Transfer/adverse effectsABSTRACT
A incidência de gestação ectópica varia de 0,3 a 1,4% das gestações espontâneas, e a ocorrência de uma gestação heterotópica é de 1:30.000. A taxa de gestação ectópica é maior naquelas com fertilização in vitro. Na fertilização in vitro, a porcentagem varia de 2,2 a 8,6%. Porém, em grupo com comprometimento tubário, esse índice pode ser maior, chegando a 11%. Gestações heterotópicas ocorrem em uma proporção de, respectivamente, 1:500 gestações com técnicas de reprodução in vitro. Podem ser destacados alguns fatores de risco, tais como comprometimento tubário, técnica inadequada e número de embriões transferidos, outros fatores não estão completamente esclarecidos do ponto de vista consensual
The incidence in ectopic pregnancy varies from 0.3 to 1.4% of all spontaneous pregnancies, and the incidence of heterotopic pregnancy is 1:30,000. The rate of ectopic pregnancy is higher in pregnancies with in vitro fertilization. Its rates range from 2.2 to 8.6%. However, in the group with tubal involvement, it is as high as 11%. Heterotopic pregnancy occurs in the incidence of 1:500 pregnancies with in vitro reproduction techniques. Some risk factors can be highlighted, such as tubal involvement, inadequate technique, number of embryos transferred, but other factors are not completely understood in terms of consensual
Subject(s)
Humans , Female , Pregnancy , Fallopian Tubes , Fertilization in Vitro/adverse effects , Pregnancy, Ectopic/epidemiology , Pregnancy, Ectopic/etiology , Sperm Injections, Intracytoplasmic/adverse effects , Embryo Transfer/adverse effects , Pregnancy Outcome , Risk FactorsABSTRACT
Heterotopic pregnancy is a catastrophic form of ectopic pregnancy and its incidence is still low but it is increasing, mainly secondary to the increase in assisted reproductive technology procedures. The definition of heterotopic pregnancy is the simultaneous development of an intrauterine pregnancy and an extrauterine one. We report a case of 33-year-old woman with intrauterine viable fetus and right tubal heterotopic pregnancy
Subject(s)
Humans , Female , Reproductive Techniques, Assisted/adverse effects , Fallopian Tubes , Embryo Transfer/adverse effects , PregnancyABSTRACT
We have presented a case of bilateral tubal pregnancy following in vitro fertilization and embryo transfer. The most likely cause, in our opinion, is 'spray effect' which was discussed. The diagnosis of ectopic pregnancy must always be kept in mind in IVF&ET program, due to its high incidence of occurrence compared to natural conception. Although the incidence of bilateral tubal pregnancy is not high, one should identify the opposite adnexa when tubal pregnancy is diagnosed in an IVF&ET patient. Early diagnosis is essential for prevention of significant maternal morbidity and mortality.
Subject(s)
Adult , Embryo Transfer/adverse effects , Female , Fertilization in Vitro/adverse effects , Humans , Infertility, Female/therapy , Pregnancy , Pregnancy Outcome , Pregnancy, Ectopic/etiology , Pregnancy, Tubal/etiologyABSTRACT
En las últimas décadas se ha registrado un incremento muy importante en la incidencia del embarazo ectópico. Esta tendencia también se ha visto reflejada en los resultados de las nuevas técnicas de reproducción asistida. La introducción de la ecografía transvaginal, combinada con la medición de los niveles circulantes de ß-hCG, ha facilitado el diagnóstico del embarazo ectópico en un estadio en el que aún puede ser asintomático, ofreciendo así la oportunidad de considerar la utilización de métodos terapéuticos mas conservadores. Dichos métodos pueden variar desde la microcirugía tubaria, hasta la actitud expectante de una resolución espontánea, apoyada sólo en el monitoreo de los niveles de ß-hCG. El presente trabajo presenta el caso de un embarazo ectópico ocurrido luego de transferencia intrauterina de gametos en una paciente con patología tubaria. El tratamiento se realizó por aspiración transvaginal del saco gestacional combinado con la instilación local y subsiguiente apoyo sistémico con metotrexate. Se presenta además una revisión de la experiencia internacional sobre el tema