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יש מחקרים רבים על ההשפעות של הפריית מבחנה על תהליך הלידה או על סיבוכים בלידה, למשל: BJOG. 2005 Nov;112(11):1529-35. Related Articles, Links In vitro fertilisation in Sweden: obstetric characteristics, maternal morbidity AND mortality. Kallen B, Finnstrom O, Nygren KG, Otterblad Olausson P, Wennerholm UB. Tornblad Institute, University of Lund, Lund, Sweden. OBJECTIVE: To investigate obstetric characteristics, maternal morbidity AND mortality among Swedish women giving birth after in vitro fertilisation (IVF) treatment. DESIGN: Register study. SETTING: Nationwide study in Sweden. SAMPLE: All women known to have had IVF in Sweden 1982-2001. METHODS: Using Swedish health registers, women who had given birth after IVF were identified from all Swedish IVF clinics AND compared with all women who gave birth. Analysis was performed with the Mantel-Haenszel technique. MAIN OUTCOME MEASURES: Diagnoses during pregnancy, at delivery AND at re-admission within 60 days after delivery AND risk of cancer. RESULTS: IVF women had an increased risk of bleeding in early pregnancy [odds ratio (OR) = 4.59, 95% confidence interval (95% CI) 4.08-5.15] AND of ovarian torsion during pregnancy (OR = 10.6, 5.69-10.7). They were also more likely to encounter pre-eclampsia (OR = 1.63, 1.53-1.74), placental abruption (2.17, 1.74-2.72), placenta praevia (3.65, 3.15-4.23), bleeding in association with vaginal delivery (1.40, 1.38-1.50) AND premature rupture of membranes (PROM) (2.54, 2.34-2.76). Interventions including caesarean sections (1.38, 1.32-1.43) AND induction of labour (1.37, 1.29-1.46) in singleton pregnancies was more frequent. The type of IVF method had little effect on these results, but there was a tendency for women who had received intra-cytoplasmatic sperm injection (ICSI) to have slightly fewer complications than women having standard IVF. There was a significant decrease in cancer risk after IVF (0.79, 0.69-0.91) but a suggested increase in the risk of ovarian cancer both before (2.70, 1.49-4.91) AND after (2.08, 1.15-3.76) IVF. No change in mortality was observed. CONCLUSIONS: Women treated with IVF had an increased obstetric morbidity. This seems to contribute little to the well-known increased risk of preterm delivery. Hum Reprod. 2002 Nov;17(11):2897-903. Related Articles, Links The course of pregnancy AND delivery AND the use of maternal healthcare services after standard IVF in Northern Finland 1990-1995. Koivurova S, Hartikainen AL, Karinen L, Gissler M, Hemminki E, Martikainen H, Tuomivaara L, Jarvelin MR. Department of Public Health Science AND General Practice, University of Oulu, P O Box 5000, 90014 Oulu, Finland. [email protected] BACKGROUND: The objective of this study was to evaluate the course of pregnancy AND delivery AND the use of maternal healthcare after IVF. METHODS: This population-based cohort study included all women who had undergone IVF treatment in Northern Finland leading to delivery in 1990-1995 (n = 225) AND control pregnancies derived from the Finnish Medical Birth Register (n = 671) matched for sex of the child, year of birth, area, maternal age, parity, social class AND fetal plurality. The analyses were stratified by plurality. Outcome measures were pregnancy complications, mode of delivery, gestational length AND the level of use of antenatal care. RESULTS: The results showed an increased risk for vaginal bleeding throughout pregnancy [relative risk (RR) 4.1, 95% confidence interval (CI) 2.5-6.7 for singletons; RR 6.9, 95% CI 2.5-19.2 for twins], threatened preterm birth (RR 1.8, 95% CI 1.1-2.9, singletons) AND intrahepatic cholestasis of pregnancy (RR 3.8, 95% CI 1.0-15.0, singletons) in IVF pregnancies, as well as an increase in the use of specialized antenatal care. CONCLUSIONS: IVF pregnancies following standard, fresh ova IVF treatments are at greater risk of obstetric problems than spontaneously conceived pregnancies, AND hence IVF mothers use more specialized antenatal care than others. The pregnancy complications after IVF are likely to be due to maternal characteristics regarding infertility AND to a high incidence of multiple pregnancies. Hum Reprod. 2002 Jul;17(7):1755-61. Related Articles, Links Obstetric outcome among women with unexplained infertility after IVF: a matched case-control study. Isaksson R, Gissler M, Tiitinen A. Department of Obstetrics AND Gynaecology, Helsinki University Central Hospital, PO Box 140, FIN-00029 HUS, Finland. [email protected] BACKGROUND: Infertility itself AND also assisted reproductive treatment increase the incidence of some obstetric complications. Women with unexplained infertility are reported to be at an increased risk of intrauterine growth restriction during pregnancy, but not for other perinatal complications. METHODS: A matched case-control study was performed on care during pregnancy AND delivery, obstetric complications AND infant perinatal outcomes of 107 women with unexplained infertility, with 118 clinical pregnancies after IVF OR ICSI treatment. These resulted in 90 deliveries; of these, 69 were singleton, 20 twin AND one triplet. Two control groups were chosen from the Finnish Medical Birth Register, one group for spontaneous pregnancies (including 445 women AND 545 children), matched according to maternal age, parity, year of birth, mother's residence AND number of children at birth, AND the other group for all pregnancies after IVF, ICSI OR frozen embryo transfer treatment (FET) during the study period (including 2377 women AND 2853 children). RESULTS: Among singletons, no difference was found in the mean birthweight, AND the incidence of low birthweight (<2500 g) was comparable with that of the control groups. No differences were found in gestational duration, major congenital malformations OR perinatal mortality among the groups studied. Among singletons in the study group, there were more term breech presentations (10.1%) compared with both spontaneously conceiving women AND all IVF women (P < 0.01). The rate of pregnancy-induced hypertension was significantly lower among singletons in the study group (P < 0.05) compared with other IVF singletons. The multiple pregnancy rate was 23.3% in the study group. The obstetric outcome of the IVF twins was similar to both control groups. CONCLUSIONS: The overall obstetric outcome among couples with unexplained infertility treated with IVF was good, with similar outcome compared with spontaneous pregnancies AND IVF pregnancies generally.