Can ultrasonography reliably predict the occurrence of multiple pregnancies in gonadotrophin ovulation induction?
| Autor: | Su Ling Yu, J. H. Evans, Roger J. Pepperell |
|---|---|
| Rok vydání: | 1991 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class Urinary system medicine.medical_treatment media_common.quotation_subject Excretion Ovarian Follicle Ovulation Induction Pregnancy medicine Humans Ovulation media_common Retrospective Studies Ultrasonography Gynecology business.industry Obstetrics and Gynecology Retrospective cohort study Estrogens General Medicine medicine.disease Quadruplets Ovulation induction Female Gonadotropin Pregnancy Multiple business Gonadotropins |
| Zdroj: | The AustralianNew Zealand journal of obstetricsgynaecology. 31(1) |
| ISSN: | 0004-8666 |
| Popis: | EDITORIAL COMMENT: This paper illustrates the limitations of ultrasonography and estimation of urinary excretion of oestrogen in prediction of multiple pregnancy when ovulation is induced by gonadotropin therapy. However, the reviewer of this paper wishes to point out to readers that the authors presumably still use these techniques and do not wish to imply that they are useless. During the time of this study of 380 cycles, there were 28 cycles abandoned (table 1) presumably in order to avoid the risk of multiple pregnancy but the details are not provided. It is noteworthy that figure 2 in this paper shows that multiple pregnancy resulted in 6 of the 10 conceptual cycles in which total urinary oestrogen excretion was 200 ug/24 hours or above; had these 10 cycles been abandoned the 1 quadruplet and 3 of the 6 triplet pregnancies would have been avoided. Summary: retrospective study of 78 patients with 106 stimulated conception cycles after successful gonadotrophin ovulation induction was made to analyze the relationship between the sizes and numbers of ovarian follicles seen on ultrasound and the eventual number of conceptions that resulted in each cycle. Fifteen cycles (14.2%) resulted in spontaneous abortions. There were 58 singleton pregnancies (54.8%), 26 sets of twins (24.5%), 6 sets of triplets (5.6%) and 1 set of quadruplets (0.9%). In 86 cycles with the last scans performed shortly before the ovulating dose of HCG, 3 or more mature follicles were found in 50 (58%). These cycles resulted in 31 (62%) singletons, 16 (32%) twin pregnancies and 3 (6%) triplet pregnancies. Pregnancies resulted even when there were no ‘mature’ follicles seen on scan. No statistical correlation was found between plurality of pregnancy and size or number of follicles, or oestradiol excretion on the day the ovulating dose of HCG was given, although high-order multiple pregnancies were more likely if the oestrogen excretion was more than 200 ug/24 hours (p = 0.001). The dosage of HCG correlated inversely with the occurrence of multiple pregnancies (p = 0.02). In conclusion, neither oestrogens nor ultrasonography could accurately predict multiple conceptions in gonadotrophin stimulated cycles. |
| Databáze: | OpenAIRE |
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