joan carles arce - new insights into single embryo transfer evidencis with hmg-hp - ii simposio...

8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn

1/34

Jkw Ijsifets ijth Tijfbk Klnryh Wrojs`kr

Kvigkjdk wite EQ-eLF

Mhoj-Dorbks Ordk, LG QeG

Pidk Qrksigkjt^kprhgudtivk Ekobte, Fbhnob Dbijidob ^&G

@krrijf Qeorlodkutidobs

II Tilphsih gk ^kprhguddij Osistigo, Logrig, >? @kn >1?7


2/34

Fj^E Ojtofhjist Qrhthdhb

Bilitkg dhlporotivk goto nktwkkj EQ-eLF ojg r@TE prkporotihjs ij Fj^Eojtofhjist dydbks

Nhsde kt ob. (>115)= ^DW J51 whlkj up th 46 ykors, IP@/IDTI, up th 4 klnryhs

trojs`krrkg ot dbkovofk stofk

EQ-eLF r@TE Q-vobuk

Kstrogihb, goy h` eDF (pf/lB) >100?1?? ?6;1964 1.1>

Qrhfkstkrhjk, goy h` eDF (jf/lB) 1.641.7> 1.991.75 21.11?

Hhdytks rktrikvkg ??.40.1 ?7.75.? 1.11?

Klnryhs trojs`krrkg ?.61.5 ?.61.5 1.67;

Hjfhijf prkfjojdy rotk 4;% 4>% 1.0?

Nhsde kt ob., Eul ^kprhg >115


3/34

[jitkg Ttotks

1%

>1%

71%

01%

51%

?11%

?999 >11? >114 >11;

7

4

>

?

Kurhpk

Jynhk Ojgkrskj, >115

>119=

>7.>%

Tijfbk Klnryh Wrojs`kr

>119= Wek eifekst prhphrtihjs h`

TKWs wkrk `hujg ij Twkgkj

(61.6%), Jhrwoy (;4.7%), Nkbfiul

(75.9%) ojg Gkjlorc (7>.1%).@krrorktti kt ob, >1?4


4/34

Wrojs`kr ot Nbosthdyst Ttofk

Nbosthdyst trojs`krs eovk nkkj osshdiotkg wite eifekr bivk nirte rotks

Qopojichbohu kt ob., JKML >1103 Eul ^kprhg >115


5/34

Wrojs`kr ot Nbosthdyst Ttofk

Fbumhvscy kt ob, Dhderojk ^kvikw >1?>


6/34

Gksifj


7/34

ôjghliskg, ossksshr-nbijg, porobbkb frhups, lubtidkjtrk, jhj-ij`krihrity triob J< 679

2 4; ykors h` ofk

?sthr >jgIP@/IDTI dydbk

NLI ?5->; cf/l>

Wrkotlkjt rkfilkj= EQ-eLF (LKJHQ[^) hr r@TE (Q[^KFHJ)

FjÊ ojtofhjist(fojirkbix 1.>; lf/goy) stortijf hj goy 0 h` silubotihj

IDTI ojg dubturk th nbosthdyst stofk(quobity kvobuotihj ny Forgjkr & Tdehhbdro`t, ?999)

Qotikjts ujgkrwkjt dhlpubshryTKWhj Goy ;

Butkob supphrt `rhl goy o`tkr hhdytk rktrikvob th eDF tkst / lkjsks (~?5->1 goys)

Pitriìdotihjh` obb surpbus nbosthdysts

?-ykor@K^= dhlpubshry TKWhj Goy BE +6 ij o joturob dydbk

LKFOTKW Wriob Gksifj

Gkvrhky kt ob., @krtib Ttkrib >1?>

Qrilory kjgphijt= Hjfhijf prkfjojdy rotk (ot bkost hjk ijtroutkrijk vionbk

`ktus ?1-?? wkkcs o`tkr nbosthdyst trojs`kr)

Jhj-ij`krihrity bilit h` -?1.1%3 QQ ojg IWW phpubotihj


8/34

?-ykor phst-rojghlisotihj

`rhzkj klnryh rkpbodklkjt(@K^) dydbks

Hjfhijf

prkfjojdy

Jh

hjfhijf

prkfjojdy

Jh

hjfhijf

prkfjojdy

Hjfhijf

prkfjojdy

@K^

? nbosthdyst

joturob dydbk

Qrkfjojdy hutdhlk ojg

jkhjotob ekobte `hbbhw-up

Qrkfjojdy hutdhlk ojg

jkhjotob ekobte `hbbhw-up

Qhst-triob hbbhw-up

reDF

>;1 f

H^0?

4 `hbbidbks ?6llKW? nbosthdyst

Hhdytk/klnryh/nbosthdyst

kvobuotihj

-eDF

?;1 I[ x ; goys

Ogmustlkjt ny

6; I[3

lijilul 7goys hj ghsk

EQ-eLF hrr@TE

Dbij. Q

Qrhfkstkrhjk

4x>11 lf

Fj^E ojtofhjist

1.>; lf

H^

+;

?4-?;

goys

o`tkr KW

;-0

wkkcs

o`tkr KW

?1-??

wkkcs

o`tkr KW

Wriob bhw

LKFOTKW Wriob Gksifj

Hjf. Q

Cky gksifj `koturks=

Vhlkj ?5-47 ykors NLI ?5->7.9 cf/l>

Jh prhfrollijf

?;1 I[ stortijf ghsk

IDTI

Nbosthdyst dubturk

Wrojs`kr hj Goy ;

Jhj-kbkdtivk TKW

> wkkcs butkob supphrt

Pitri`idotihj @rhzkj joturob dydbk

@rhzkj jhj-kbkdtivk TKW


9/34

LKFOTKW Nihlorckrs Ijvkstifotihjs

Tkrul prhìbk

@TE Kstrogihb OLE

BE Qrhfkstkrhjk Ije N

eDF Whtob tksthstkrhjk

Qrhbodtij TENF

@OI

@hbbidubor `buig

ehrlhjks ojg

dythcijks

Qhtkjtiob lorckrsh` klnryh quobityojg ilpbojtotihj

ktd

Fkjk kxprkssihjDulubus dkbbs

@ubb prhìbk nylidrhorroy

^kob-tilk _-QD^h` rkbkvojt fkjks

[tkrijk dhjtrodtibity

Nbosthdystlhrpehbhfy

^kbotihjseip thtrkotlkjt hutdhlk

4G lhgkbbijf h` kjghlktriul

Kjghdrijk

prhìbk

Hhdytk thnbosthdyst

[tkrus

ojg kjgh-

lktriul


10/34

LKFOTKW Nihlorckrs Ijvkstifotihjs

Tkrul prhìbk

@TE Kstrogihb OLE

BE Qrhfkstkrhjk Ije N

eDF Whtob tksthstkrhjk

Qrhbodtij TENF

@OI

@hbbidubor `buig

ehrlhjks ojg

dythcijks

Qhtkjtiob lorckrsh` klnryh quobityojg ilpbojtotihj

ktd

Fkjk kxprkssihjDulubus dkbbs

@ubb prhìbk nylidrhorroy

^kob-tilk _-QD^h` rkbkvojt fkjks

[tkrijk dhjtrodtibity

Nbosthdystlhrpehbhfy

^kbotihjseip thtrkotlkjt hutdhlk

4G lhgkbbijf h` kjghlktriul

Kjghdrijk

prhìbk

Hhdytk thnbosthdyst

[tkrus

ojg kjgh-

lktriul


11/34

Cky @ijgijfs

Qrilory hnmkdtivk

OLE

Qrhfkstkrhjk ojg trkotlkjt hutdhlk Nbosthdyst quobity ojg trkotlkjt hutdhlk


12/34

Kjg h` Ttilubotihj ojg Hhdytk ^ktrikvob

1

>

7

0

5

?1

?>

1 ? > 4 7 ; 0 6 5 9 ?1 ?? ?> ?4 ?7 ?; ?0 ?6 ?5 ?9 >1 >? >> >4 >7 >; >0 >6 >5 >9 41 4? 4> 44 47 4;

@rkqu

kjdy(%)h`potikjt

s

Julnkr h` hhdytks rktrikvkg

EQ-eLF

r@TE

EQ-eLF r@TE p

Qrkloturk BE risk 0% 0% JT

Kstrogihb (plhb/B) 56960141 61>>797; 21.11?

Qrhfkstkrhjk (jlhb/B) >.0>.0 >.0>.0 JT

Hhdytk rktrikvob 96% 96% JT

Hhdytks rktrikvkg 9.?;.> ?1.6;.5 21.11?



13/34


14/34

71

4>

41 >9

40

>9>6

>0

1

?1

>1

41

71

QhsitivkeDF

Dbijidobprkfjojdy

Hjfhijfprkfjojdy

Bivk nirte

%

Qrkfjojdy ojg Bivk Nirte

QQ-phpubotihj IWW-phpubotihj

Qkr stortkg dydbk

49

4?

>9 >5

40

>9>6 >0

1

?1

>1

41

71

QhsitivkeDF

Dbijidobprkfjojdy

Hjfhijfprkfjojdy

Bivk Nirte

%

EQ-eLF

r@TE

4.1% (-4.53 9.5) >.>% (-7.>3 5.0)Wrkotlkjt gi``krkjdk (9;% DI)

Qrilory kjgphijt



15/34

75

49

40 4;

7>

474>

41

1

?1

>1

41

71

;1

QhsitivkeDF

Dbijidobprkfjojdy

Hjfhijfprkfjojdy

Bivk nirte

%

Qrkfjojdy ojg Bivk Nirte

QQ-phpubotihj IWW-phpubotihj

Qkr dydbk wite trojs`kr

75

45

4; 4;

7>

474>

41

1

?1

>1

41

71

;1

QhsitivkeDF

Dbijidobprkfjojdy

Hjfhijfprkfjojdy

Bivk Nirte

%

EQ-eLF

r@TE



16/34

Bivk Nirte o`tkr ?-ykor Dryhprkskrvkg Dydbks

>9

71

>0

45

1

?1

>1

41

71

;1

@rkse Dulubotivk

%

EQ-eLF

r@TE

>5

71

>0

45

1

?1

>1

41

71

;1

@rkse Dulubotivk

%QQ-phpubotihj IWW-phpubotihj

EQ-eLF r@TE

Hhdytks rktrikvkg 9.?;.> ?1.6;.5

@rhzkj nbosthdysts ?.5>.7 >.?>.5



17/34

OLE


18/34

OLE Is tek Nkst Qrkgidthr h` Hvorioj ^ksphjsk

OLE Nosob @TE O@D

Ordk kt ob., @krtib Ttkrib >1?4


19/34

Bhw rksphjsk(27 hhdytks rktrikvkg hr dydbk dojdkbbotihj

guk th phhr rksphjsk)

Eife rksphjsk(?; hhdytks rktrikvkg hr dydbk dojdkbbotihj

guk th kxdkssivk rksphjsk)

?-Tpkdi`idity

1.1 1.> 1.7 1.0 1.5 ?.1

Tkjsitivity

1.1

1.>

1.7

1.0

1.5

?.1

OLE (O[D < 1.596)

@TE (O[D < 1.6?9)

Ijeinij N (O[D < 1.046)

O@D (O[D < 1.67?)

?-Tpkdi`idity

1.1 1.> 1.7 1.0 1.5 ?.1

Tkjsitivity

1.1

1.>

1.7

1.0

1.5

?.1

OLE (O[D < 1.5?4)

@TE (O[D < 1.64?)

Ijeinij N (O[D < 1.;47)

O@D (O[D < 1.040)

1.5961.5?4

OLE Doj Qrkgidt Bhw ojg Eife ^ksphjsk

Ordk kt ob., @krtib Ttkrib >1?4


20/34

OLE vs O@D os Qrkgidthr h` Hvorioj ^ksphjsk

Ordk kt ob., @krtib Ttkrib >1?4 (n)

Ojobysis h` ijgiviguob dbijids goto wite rkspkdt th pkr`hrlojdk h` OLE ojg O@Dos prkgidthr h` julnkr h` hhdytks rktrikvkg

OLE [email protected];6; 1.7;;66

1.;7?4? 1.76161

1.;5?17 1.;>>?0

1.6;0>4 1.>0474

1.0;149 1.70;>0

1.019?7 1.716;?

1.;667? 1.?9701

1.;7449 1.705?6

1.05>;; 1.6;;51

1.;?716 1.4440>

1.06174 1.>51>4

1.;1951 1.;6170

1.6?54? 1.79070

1.79>;4 1.4;1?51.;9754 1.;??17

1.005?9 1.797>;

1.45>>4 1.>4>66

1.>61?? -1.17?;>

Dbijids ?1 potikjts Dbijids >; potikjts

OLE eos eifekr dhrrkbotihjdhk``idikjt th julnkr h`hhdytks rktrikvkg teoj O@D

ij ?0 h` ?5 dbijids

OLE O@D1.;5?17 1.;>>?0

1.0;149 1.70;>0

1.019?7 1.716;?

1.;667? 1.?9701

1.;7449 1.705?6

1.;1951 1.;6170

1.79>;4 1.4;1?5

1.;9754 1.;??17

Lubtipbk rkfrkssihj ojobysis(silubtojkhus ijdbusihj3 ubb gotoskt)

OLE= p21.111?O@D= p


21/34

Hvorioj ^ksphjsk ojg HETT / Ijtkrvkjtihjs

ny OLE _uortibks (EQ-eLF vs r@TE)

r@TE wos osshdiotkg wite eifekr hhdytkyikbgs ij _>, _4 ojg _7, dhlporkg th EQ-eLF. Vekrk nihbhfy rkstridtkg tek `hbbidubor

rkdruitlkjt (_?), tekrk wos jh gi``krkjdk.Ordk kt ob., @krtib Ttkrib >1?4

Qkrdkjtofk h` potikjts wite korby

HETT hr so`kty ijtkrvkjtihjs guk thkxdkssivk hvorioj rksphjsk

Ijtkrvkjtihjs= dydbk dojdkbbotihj guk thkxdkssivk rksphjsk, porodkjtksis, obnulijoglijistrotihj

Julnkr h` hhdytks rktrikvkg

OLE quortibk

Hhdytksrktrikvkg

1

;

?1

?;

>1

>;

41

EQ-eLF

r@TE

04 0>

57

?17

??;

?>0

?>0

?70

_? _> _4 _7

OLE quortibk

%

1

>

7

0

5

?1

?>

?7

?0

EQ-eLF

r@TE

_? _> _4 _7

?

4 4 4

7

9

?1

?;


22/34

Eypkr-rksphjsk ojg Bivk Nirte ij OLE _7

4?

79

1

>1

71

01

_7

%

47

>4

1

?1

>1

41

71

_7

%

?; hhdytks Bivk nirte

OLE eifekst quortibk EQ-eLFr@TE

p


23/34

Qrhfkstkrhjk


24/34

Hjfhijf Qrkfjojdy ^otk Oddhrgijf th

Qrhfkstkrhjk Bkvkb ot Kjg h` Ttilubotihj

?.; jf/lB< 7.66 jlhb/B ?.; jf/lB< 7.66 jlhb/B

Tkrul Q hj goy h` eDF (jf/lB)

?.11

Lkoj

hjfhijfprkfjojdyro

tk(%)

01

;1

71

41

>1

?1

1

?.1??.>; ?.>0?.;1 ?.;??.6; ?.60>.11 :>.11

Ofhjists (j


25/34

Hjfhijf Qrkfjojdy

ny Qrhfkstkrhjk ot Kjg h` Ttilubotihj

Goto hj `ibk

p21.1;


26/34


27/34

Hjfhijf Qrkfjojdy


44%

>.4 4.;

Goto hj `ibk

Ovkrofk hjfhijf prkfjojdy

rotk pkr dydbk wite trojs`kr

p21.1;

JT


28/34

>9 41>9

?0

1

?1

>1

41

71

Q7 7 jlhb/B Q7 : 7 jlhb/B

Hjfhijfprkfjojdy(%

)

Qrhfkstkrhjk ot kjg h` stilubotihj

EQ-eLF

[email protected];

J


29/34

Hjfhijf Qrkfjojdy


>9 41>9

?0

1

?1

>1

41

71

Q7 7 jlhb/B Q7 : 7 jlhb/B

Hjfhijfprkfjojdy

(%)


EQ-eLF

r@TE

p21.1;

>9

47

?9

>9

>?

6

1

?1

>1

41

71

Q7 7 jlhb/B Q7 :7-;.0 jlhb/B Q7 :;.0 jlhb/B

Hjfhijfprkfjojdy

(%)


EQ-eLFr@TE

?.>0 jf/lB < 7 jlhb/B

?.60 jf/lB < ;.0 jlhb/B

Goto hj `ibk


30/34

Nbosthdyst _uobity


31/34

Nbosthdyst Lhrpehbhfy

Oebstrl kt ob

Eul ^kprhg >1??

Eibb kt ob

@krtib Ttkrib >1?4

Ehjjlo kt ob

@krtib Ttkrib >1?>

Poj gkj Onnkkb kt ob

^NL hjbijk >1?4

j % j % j % j %

Kxpojsihj ojg

eotdeijf

0 1 1{ 95 { ?7

;7 ; 1 1

; 1 1 7>7 49 ?;> >;7 70; 7>

{ ;77 { 66746 71 >;; 7?

4 716 40 ?6> ?0 ?10 ?6

> ?;7 ?7 ;> 6 - - ;> 5

? 61 0 1 1 - - ;4 9

1 >? > - - - - - -

Ijjkr dkbb loss

O 00; 60 0?9 59 090 07 >61 ;4N >11 >4 64 ?1 400 47 ?57 40

D 6 ? > ? >; > ;9 ?>

Wrhpekdthgkrl

O 709 ;7 ;>1 6; 47? 4? >4; 70

N 465 74 ?00 >7 056 04 >?6 7>

D >; 4 5 ? ;9 ; 0? ?>

Gistrinutihj h` nbosthdysts oddhrgijf th ijgiviguob lhrpehbhfy porolktkrs


32/34


33/34

Dhjdbusihjs


34/34

Dhjdbusihjs

EQ-eLF is ot bkost os k``kdtivk ij odeikvijf prkfjojdy os r@TE wekj uskg `hr

dhjtrhbbkg hvorioj stilubotihj ij o FjÊ ojtofhjist dydbk wite dhlpubshry sijfbk

nbosthdyst trojs`kr.

@urtekr kvigkjdk wos prhvigkg teot teksk fhjoghtrhpij prkporotihjs orkosshdiotkg wite gi``krkjtiob `hbbidubor rksphjsk ojg skrul kjghdrijk prhìbk gurijf

tek stilubotihj peosk.

Wek triob goto supphrtkg tek rhbk h` OLE os prkgidthr h` hvorioj rksphjsk th

fhjoghtrhpij tekropy ojg tek ij`bukjdk h` skrul prhfkstkrhjk hj trkotlkjt

hutdhlk.

@urtekr borfk lubtidkjtrk gotoskts lifet ekbp th kbudigotk tek spkdiìd rhbk h` kode

nbosthdyst lhrpehbhfy porolktkr hj trkotlkjt hutdhlk.

joan carles arce - new insights into single embryo transfer evidencis with hmg-hp - ii simposio...

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