Singleton pregnancy compare risk of twin & singleton Pregnancies IVF

what is a singleton pregnancy

Think of the Miserable Situation Twin and Singleton Pregnancies from IVF

what is a Singleton Pregnancy Or singleton pregnancy and activity the single embryo or more correctly single elective embryo transfer is a concept that arose probably approximately

Singleton Pregnancy Definition a few years ago Scandinavia more specifically initially in Finland but then swept Scandinavia swept the large part of

European countries and now in recent years has also started sweeping across the Atlantic into the US and Canada it is

basically the idea that twin pregnancies represent an adverse outcome of fertility treatment or IVF meaning that twin

pregnancies should be avoided and the argument that our colleagues make in reaching this conclusion is that risks to

mothers and offspring from twin pregnancies are higher than from singleton pregnancy and that is obviously correct

but that is a statistically different consideration than the consideration,

we have in Reproductive Endocrinology and

infertility for the following reasons when an obstetrician compares twin pregnancy to a singleton pregnancy is a retrospective

review they delivered twin pregnancy they deliver singleton pregnancy and now they look at complications to mom

and offspring in those two pregnancies and compare and obviously,

Twins have a higher risk both on the maternal side

and on the baby side but that is not the paradigm that

we in infertility follow ours is a prospective parade

patients come to us and say doctor help may have the pregnancy and I’m asking the patient do you have children no I

don’t have children do you want one child two-three whether your plans

If the Mother I want two children then for me, 

the question to answer the statistical question answer is how to do I prospectively give this patient to

help this patient to achieve two children and for a moment assuming that I could undemanding ends which

we obviously cannot but assuming for a moment for statistical considerations that

we could work me therefore the

options are to either help her have twins one pregnancy with two children or two consecutive pregnancies of one each

to singles because the end product is to children and in statistics,

If you want to make a difference between two treatments the outcome

needs to be the same

so in contrast to the obstetrical analysis where the comparison is one child versus two children,

here I have to compare one twin pregnancy to two single and that is obviously a completely different statistical

observation because I have to add up the risks of two singles and it turns out when that is done the risk difference

becomes very minimal there is no major additional risk to twins versus two consecutive signals there are some but

they are really minor a few more days in the intensive care unit for example but there are no long-term there’s no risk

of mortality, there’s no risk of long-term morbidity mother children of any sickness

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Hello everyone I am a doctor to mummy says

I want the mentor office in mice using him yeah I’m willing to discuss one of the important coping don’t think that has been simplified leak in January 2020

talk and the scenes antenatal management all singleton pregnancies concept using Iraqi that the assisted reproductive technology.

So you will know that it’s so it is increasing day by day worldwide wide and about 1.5 % of the baby born had been conceived through IVF.

And dole it sub outcome overall not.

Right these air deficit to beat our mac Donald and future complications

so it’s a very high-risk pregnancy we should closely monitor the vehicle it Nancy Adam in any competition our eyes

we can not only diagnose and we can’t wait that long.

So if you can classify these Art complications like anti-pregnancy complications they can be classified as an early

pregnancy company location I can not complication.

We don’t need it. Asian. At. Last. Ten.com to get sent

so 1 by 1 will discuss the complication and they will discuss the management plan so in early pregnancy complications

1 of the important complication that can occur in any E. R. T. at is liberty and hyperstimulation syndrome and it’s quite

common so the majority of the cases that occur in a minor fall 19.33 %of the fuses and in the moderate and severe

pocket is R. or read 31.18 % of the cases

so if anything it’s symptoms that can suspect that it’s not over yet advanced emissions scandal we should admit the

the case for assessment and for management and we should inform the public the clinic about admission and diagnosis

and in all cases all CPR and Reggie got over in hyperstimulation syndrome market declining should report to the

the human park lies action and embryology authority

so these are the things you have to follow if you face any gays who are

already in hyperstimulation syndrome falling right yet to pregnancy,

the next common complication is miscarriage about 15 to 20 % of that is this act.

Congregations no it’s not here yet like 1.-1.4 % on that use this weekend all right that is an ectopic pregnancy

I and indeed still gazes the management just like the same as

we had done any miscarriage or

ectopic pregnancy following us wanting fewer conceptions.

But as this pregnancy is very I’m already up a welcoming for the battle bother

so these are the situations that can affect their psychological condition

so they should have access to a specialized counselor before during and after the artificial reproductive technique.

In case of maternal complications,

one of the important complications and I realized that this pregnancy-induced

hypertension at a glance yeah next one is at the station of diabetes mellitus pregnancy-induced hypertension but

Andres is about 2 % just as you know that it is not like this overall the risk is about 1 % and we did that is been asked

so we will use all the chances I asking was that Mr in all their gazes for risk assessment we can follow the local and

national guidelines that are you know that in case of pregnancy news application and D. D. M. there’s a nice guideline

and floor of the deeper pilot since our management there isn’t DTZ died name that is ranked up I thank

so far the risk assessment we should follow that guideline and even there’s no risk in beer in gays all pregnancy-

induced hypertension preeclampsia events center there’s no rule of Aspin provided since I in absence of any race or

any decision on that but it’s not like that there’s no indication or

glucose tolerance test and.

in case No B. T. there’s no risk I am back legacy there’s no door lock and take what lessons the only we can tell them to comparable visit

so that we can **** the rest and echo into the race began man is the pregnancy to prevent any kind of complication.

The next is based on vacations stock your lab abnormalities ice 30 to 40 % increased incidence

dole the risk still low that is an absolute state at risk is too low that is 5 to 7 %

so in this game, this nor indigenous arguments are becoming debt

so only in that case like a normal pregnancy,

they can sink their company names as we are doing something on my

contesting in first and second time Mr an animal is that testing in 18 to 20 weeks only we can do that yeah there’s no

additional surveillance is recommended in gaze up in a day there’s an outside chance of growth restrictions if there

are no risk factors yes they did with the pregnancy there’s no need for any additional surveillance 19 there’s nobody’s

called obesity and name, yeah I’d like any.

Chain-smoking on any L. massive alcohol intake or

any previous is still by any medical disease are you making are

back then I’ll is yet is going is seen that gazes no additional star lenses become and that there’s a chance of stillbirth is there

so some of the consultants can consider induction of labor at the town there isn’t also a chance of preterm

labor the chances hi like an 11.2 % of the gazes but the majority of the kids up on all this actor Danny.

And but in preterm labor as the town of calls mostly actor Danny

so no additional surveillance is the, under in gaze up yet to pregnancy.

In case black baton pass into a complication, there’s a chance of pleasant happy days they’re pleasant to

actually do their lessons and Robson is via but in these cases, no edition on surveillance is the, and that

we can do only an ultrasound in 18 to 20 weeks if you see that the present days no light according to the guidelines

we can’t follow the management or

ask meant bought by their persistence all blacks and W. and gives a bus company via

so you know that is out of the woods video but it sent one of the top CDS complications that can occur in the pregnancy

so during animals can you concede that plug into is no line so in that case,

we can consider a transvaginal scan

we got a dog not to exclude the possibility, yeah

so it’s very important in the active pregnancy you see a pleasant day nor lying in animals can you should do other

trials but then I’ll scan with the color doppler it’s not this possibly via.

So regarding the pharmacological intervention

so these are the medications that are nowadays

we are practicing but

we should think that that we should see the guide led by their deeds

so medications are needed I’m not

so far as you ask me so in unexplained Rick and sometimes

we can consider asked waiting but in Iraq,

it does not then if

we stop that engages all granulocyte colony-stimulating factor I’ll floor in your recurrent implantation failure are

persistent in an intimate jam all recurrent miscarriage there’s very limited evidence of benefit that means it’s also not

needed in gays all SEG with the recurrent miscarriage or

pretend miscarriage there’s no benefit dog back in Kansas history I

if the patient has any history of antiphospholipid syndrome and recurrent miscarriage that will be considered your

body and that will be dealt the miscarriage rate increase okay D. L. recurrent miscarriage an inmate at a Trumbull yeah

our only issue of recurrent miscarriage or

woman undergoing EMT there’s very limited evidence benefit

so that means only in case no one really big S.

and room and

we got in the big names and economies got it in decades began considering it brings reduce miscarriage rate.

The next is immunotherapy or

woman with a history of recurrent implantation failure all recurrent miscarriage there is no benefit

I in fact it can cause some side effects like and a pilot in the separation and dental markets diseases and introduce Teryl Appling an anti-pregnancy

we can consider using the luteal phase or

lead that increases the clinical pregnancy rate and life but a great woman

with recurrent miscarriage is checked in miscarriage there’s no benefit dump that.

I’m on days off it can’t log media L.

steroids

we don’t recommend these guys are raised you dry natural killer cell in that there is at least limited evidence of

benefits that mean any active pregnancy I debated how many is still out recurrent miscarriage and people’s

antibodies and all weekend gave heparin to reduce the miscarriage rate and falling in here to eat bread Nancy

we can consider for the strong only yeah 8 that can increase the pregnancy rate at also 9 Bucks right the only be if the medications

we get guns in there.

Regarding the time and model delivery.

You got them although they lived right up until something here is that as it does include the inbox rate

so I’ll we can configure induction of labor at now but on the other hand and there’s no need to let Dennis that it increases the interventions like emergency cesarean sections

so I the decision all model delivery and Thailand anybody that maybe is that decided by only by the wall meant just what

we can do that you can give them options and

we can tell them about benefits and risks and although the alternatives benefit center is and women get guns in there which options you want to go okay

so but there’s some evidence that that get inconsistent but great

so some of the cases

we can consider off-label.

Okay so that’s all about is a small dog bill it’s very small but it’s very important as because it’s a very resent all built still some questions can come from these talks.

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