Terveet lihavat - onko heitä?

Siirretty Doriast

Vuotohäiriöt fertiili-iän ääripäissä

Vertaisarvioitu. English summary. Teema : gynekologiset vuotohäiriöt.Toiminnallisten vuotohäiriöiden tavallisin syy on anovulaatio. Sitä esiintyy yleisimmin hedelmällisen iän ääripäissä eli parin vuoden ajan kuukautisten alkamisen jälkeen ja menopaussin siirtymävaiheessa eli perimenopaussissa. Syynä tähän on hypotalamus-aivolisäke-munasarja-akselin toimintahäiriö. Nuorilla taustalla on säätelyn kypsymättömyys ja perimenopaussissa munasarjatoiminnan hiipuminen. Anovulaatiossa progesteronin stabiloiva vaikutus kohdun limakalvon rakenteeseen jää puuttumaan. Vuotohäiriön diagnosointi ja hoito voidaan aloittaa perusterveydenhuollossa. Diagnostiikan kulmakiviä ovat tarkka oire- ja vuotoanamneesi sekä yleisvoinnin tarkistus. Nuorilla ensisijaisena hoitona ovat yhdistelmäehkäisytabletit ja perimenopausaalisilla progestiinivalmisteet. Jos tavanomaisella hormonihoidolla ei saada hoitovastetta, potilas lähetetään erikoissairaanhoitoon. Yleistilaltaan heikko ja aneeminen potilas on syytä lähettää naistentautien päivystykseen.Peer reviewe

The Impact of the Use of Neonicotinoid Insecticides on Honey Bees in the Cultivation of Spring Oilseed Crops in Finland in 2013–2015

The Neomehi project studied how neonicotinoid-based plant protection products affected honey bee colonies in oilseed rape and turnip rape cultivations in Finland. The final report combines the results of the growing seasons of 2013 and 2014. The experimental protocol included four trial fields where spring turnip rape was cultivated. Each trial field was treated in a different manner with neonicotinoid insecticides: without neonicotinoids, foliar spraying with neonicotinoids (thiacloprid) against pollen beetles, and/or seed treatment with neonicotinoids (thiametoxam) against flea beetles. The plant density and crop growth were determined in the trial fields. Additionally, the number of honey bees and other pollinators was assessed with the applied line transect method during the growing season. Five test bee colonies were located at the edge of each trial field. The performance of the bee hives was examined and the amount of bees and brood was counted 4-5 times during the summer season. A census was also done in autumn and in spring in order to acquire overwintering data. The bees and bee hive products from the test bee colonies were analysed for residues of neonicotinoids. Moreover, in the epidemiological pilot study (also called survey study in the text) of 2013-2014, residues were also analysed from samples collected as a survey from bee hives from five different geographical areas in Finland. In 2013, the sampling was optimized so that half of the bee hives were located close to oilseed cultivation and the other half far from oilseed cultivation. The crop growth was normal in three of the trial fields during the growing season of 2013. In one trial field (seed treatment with neonicotinoids), the crop growth probably suffered because of the variation in drilling depth. In 2014, both trial fields with uncoated seed had to be redrilled after flea beetles severely attacked the young plants in the fields. Therefore, the blossoming of turnip rape in those trial fields was delayed from late July to the beginning of August. The yield was low as well. The number of honey bees in the trial fields was higher when crop growth was good and lower when crop growth was poor. In three of the four fields that were treated with foliar spraying with a neonicotinoid (thiacloprid), the number of honey bees decreased after the treatment. The number of honey bees did, however, clearly increase 2-3 days after the foliar treatment. Both the adult and brood population dynamic curves of the test bee colonies were compared between trial sites. The adult bee population curves illustrated possible minor damages caused to the bee colonies in the sprayed test sites. The test bee colonies recovered from these casualties in two weeks. The average range of food consumption for the bees during overwintering and the overwintering index (the relation of the number of adult bees in spring compared to the number of adult bees in the beginning of overwintering) demonstrated typical levels compared to normal bee colonies in South-West Finland and there were no difference between the trial fields. Two of the test bee colonies lost their queen during winter 2013-2014. In 2014, one of the test colonies died due to suffocation because the pollen collector at the flight entrance was blocked by drones. The second test colony was lost because of robbing by other bee colonies after harvesting. A third test colony lost its queen during winter 2014-2015 and a fourth became a drone layer in the early spring of 2015. The winter losses of the test bee colonies did not differ from the average winter losses (7% in 2014 and 10% in 2015) in the South-West of Finland. The results of the first and second growing season did not indicate that seed coating with neonicotinoids affected the success of the bee colonies, but spraying the flowering field can be detrimental to the bee colonies that are located at the edges of the trial fields. The results of the residue studies indicated, however, that residues of neonicotinoids migrate into bee hives with pollen and nectar and are very common residues in honey bee hives around Finland. In this case, interest is focused on the seed treatment neonicotinoids thiametoxam and clothianidin, which are the most toxic pesticides to bees. The total residue levels of thiametoxam and chlothianide, especially in nectar, resulted in an estimated exposure, which is close to the chronic and acute sublethal risk limits presented in literature. Therefore, such a risk cannot be fully excluded on the basis of these residue studies.ABSTRAKTI Neomehi-hankkeen tärkein tavoite oli selvittää vaikuttavatko neonikotinoideja sisältävät torjunta-aineet pölytyspalvelussa käytettyjen mehiläispesien menestykseen ja talvehtimiskykyyn. Hankkeessa tutkittiin kahden kasvukauden ajan minkälaisia vaikutuksia rypsinviljelyssä käytettävillä, neonikotinoideja sisältävillä torjunta-aineilla on mehiläisiin suomalaisessa öljykasvin viljelyssä. Nyt julkaistava hankeraportti kokoaa yhteen kaksivuotisen Neomehi-hankkeen keskeisimmät tulokset. Koejärjestely sisälsi neljä kenttäkoetta kumpanakin kasvukautena 2013–2014, joissa viljeltiin rypsiä. Neonikotinoideja sisältäviä insektisidejä käytettiin eri tavoin kullakin pellolla. Koepellolla joko ei käytetty neonikotinoideja tai ruiskutettiin neonikotinoidilla (tiaklopridi) kirppoja vastaan ja/tai käytettiin neonikotinoidilla peitattua (tiametoksaami) siementä rapsikuoriaisia vastaan. Kasvien kasvua ja kasvutiheyttä seurattiin, ja pelloilla vierailevien mehiläisten ja muiden pölyttäjäryhmien esiintyminen laskettiin kasvukauden aikana. Kunkin pellon laidalla pidettiin viittä mehiläispesää. Mehiläispesien kuntoa seurattiin ja mehiläisten ja niiden jälkeläisten lukumäärä laskettiin vähintään neljällä eri tarkastuskäynnillä kesän aikana. Vahvuuslaskentoja tehtiin myös syksyjen 2013 ja 2014 aikana sekä keväällä 2014 ja 2015. Tällöin saatiin tarkempaa tietoa molempien hoitovuosien talvehtimisesta. Mehiläisiin ja mehiläispesän tuotteisiin kerääntyviä neonikotinoidien jäämiä analysoitiin kaikista kenttäkokeen pesistä. Kenttäkokeen lisäksi molempina kesinä 2013–2014 kerättiin näytteitä mehiläispesistä otantana viideltä eri alueelta Suomessa (epidemiologinen pilottihanke, otantatutkimus). Vuonna 2013 otantatutkimuksen näytteet valittiin siten, että puolet pesistä sijaitsi lähellä rypsinviljelyä ja puolet kaukana. Kasvien kasvu ja kukintojen tiheys oli normaalia kolmella koepellolla vuonna 2013. Yhdellä pellolla kasvu ei ollut niin hyvää johtuen todennäköisesti väärästä kylvösyvyydestä. Vuonna 2014 peittaamattomalla rypsin siemenellä kylvetyt kentät jouduttiin kirppojen vioitusten takia kylvämään uudestaan, jonka seurauksena niiden kukinta oli vasta heinä-elokuun vaihteessa. Pölyttäjälaskennat osoittivat, että pääsääntöisesti mehiläisten lukumäärä pellolla oli korkea, kun kasvin kasvu oli hyvä ja kukintoja runsaasti ja toisaalta taas mehiläisten lukumäärä alhainen kun kasvin kasvu heikkoa. Tällöin esimerkiksi ympäristössä olevat luonnonkasvit houkuttelivat mehiläisiä merkittävästi puoleensa. Koekentillä, jotka käsiteltiin neonikotinoidi-ruiskutuksella, ei mehiläisiä juuri havaittu heti ruiskutuksen jälkeen. Muutama päivä käsittelystä mehiläisten lukumäärä pellolla oli kuitenkin palautunut ruiskutusta edeltäneeseen tilaan. Ensimmäisen ja toisen kauden tulosten perusteella havaittiin, että neonikotinoideilla kukkivaan kasvuston tehdyt ruiskutukset saattoivat alentaa hieman koepesien aikuisten mehiläisten määrää. Mehiläispesät kuitenkin toipuivat menetyksistä kahden viikon kuluessa. Myös talvenaikainen ruoankulutus sekä talvehtimisindeksi (mehiläisten lukumäärän suhde syksyllä ja keväällä) asettuvat tyypillisiin arvoihin, joita mehiläisyhdyskunnille on mitattu Lounais-Suomessa, eivätkä eri koekenttien mehiläispesät poikenneet toisistaan tässä suhteessa. Talven 2013–2014 aikana kaksi pesää menetti kuningattaren. Toinen pesä oli koekentällä, jota ei käsitelty neonikotinoideilla ja toinen kentällä, jossa neonikotinoideja oli käytetty siementen peittaukseen. Hoitokaudella 2014 yksi pesistä tukehtui, kun kuhnurit tukkivat siitepölykeräimen. Toinen pesistä menetettiin koekentällä 3, kun muiden pesien mehiläiset ryöstivät sen tyhjäksi sadonkorjuun jälkeen. Talvella 2014–2015 yksi pesä menetti emonsa ja yhden pesän emo alkoi munia kuhnureita aikaisin keväällä 2015. Talvehtimistappiot eivät eroa koko Suomen keskiarvosta (7% 2014 ja 10% 2015). Jäämätutkimusten perusteella neonikotinoidien jäämiä siirtyy siitepölyn ja meden mukana mehiläispesiin. Peittausaineiden jäämät (tiametoksaamin, klotianidiinin) ovat erittäin yleisiä mehiläispesissä ympäri Suomen. Mitatut jäämäpitoisuudet etenkin medessä johtavat arvioon altistumistasosta, joka on lähellä kirjallisuudessa esitettyjä kroonisia ja akuutteja subletaaleja riskirajoja. Jäämätulosten perusteella ei voida siis täysin pois sulkea tämäntyyppistä riskiä.201

Interlaboratory Proficiency Test 10/2018 - Metals in waste water and compost

Proftest SYKE carried out the proficiency test (PT) for analysis of elements in waters and compost material in October November 2018. The measurands for the synthetic and waste water samples were: Al, As, B, Ba, Ca, Cd, Co, Cr, Cu, Fe, Hg, Mg, Mn, Mo, Ni, Pb, Sb, Se, Sn, Sr, Stot, V, and Zn. For the compost sample the measurands were: As, Ca, Cd, Cr, Cu, Fe, Hg, K, Mg, Mn, Mo, Ntot, Ni, Ptot, Pb, Stot, V, and Zn. In total 21 laboratories participated in the PT. In total, 90 % of the results evaluated with z scores were satisfactory when total deviation of 10–25 % from the assigned value was accepted. From the results evaluated with En scores, 72 % were satisfactory. Basically, either the metrologically traceable concentration, calculated concentration, the robust mean, the mean or the median of the results reported by the participants was used as the assigned value for measurands. Warm thanks to all the participants of this proficiency test

ART in Europe, 2017: results generated from European registries by ESHRE

© The Author(s) 2021. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.Study question: What are the data on ART and IUI cycles, and fertility preservation (FP) interventions reported in 2017 as compared to previous years, as well as the main trends over the years? Summary answer: The 21st ESHRE report on ART and IUI shows the continual increase in reported treatment cycle numbers in Europe, with a decrease in the proportion of transfers with more than one embryo causing an additional slight reduction of multiple delivery rates (DR) as well as higher pregnancy rates (PR) and DR after frozen embryo replacement (FER) compared to fresh IVF and ICSI cycles, while the number of IUI cycles increased and their outcomes remained stable. What is known already: Since 1997, ART aggregated data generated by national registries, clinics or professional societies have been gathered and analyzed by the European IVF-monitoring Consortium (EIM) and communicated in a total of 20 manuscripts published in Human Reproduction and Human Reproduction Open. Study design size duration: Data on European medically assisted reproduction (MAR) are collected by EIM for ESHRE on a yearly basis. The data on treatments performed between 1 January and 31 December 2017 in 39 European countries were provided by either National Registries or registries based on personal initiatives of medical associations and scientific organizations. Participants/materials setting methods: Overall, 1382 clinics offering ART services in 39 countries reported a total of 940 503 treatment cycles, including 165 379 with IVF, 391 379 with ICSI, 271 476 with FER, 37 303 with preimplantation genetic testing (PGT), 69 378 with egg donation (ED), 378 with IVM of oocytes, and 5210 cycles with frozen oocyte replacement (FOR). A total of 1273 institutions reported data on 207 196 IUI cycles using either husband/partner's semen (IUI-H; n = 155 794) or donor semen (IUI-D; n = 51 402) in 30 countries and 25 countries, respectively. Thirteen countries reported 18 888 interventions for FP, including oocyte, ovarian tissue, semen and testicular tissue banking in pre- and postpubertal patients. Main results and the role of chance: In 21 countries (20 in 2016) in which all ART clinics reported to the registry, 473 733 treatment cycles were registered for a total population of approximately 330 million inhabitants, allowing a best-estimate of a mean of 1435 cycles performed per million inhabitants (range: 723-3286).Amongst the 39 reporting countries, the clinical PR per aspiration and per transfer in 2017 were similar to those observed in 2016 (26.8% and 34.6% vs 28.0% and 34.8%, respectively). After ICSI the corresponding rates were also similar to those achieved in 2016 (24% and 33.5% vs 25% and 33.2% in 2016). When freeze all cycles were removed, the clinical PRs per aspiration were 30.8% and 27.5% for IVF and ICSI, respectively.After FER with embryos originating from own eggs the PR per thawing was 30.2%, which is comparable to 30.9% in 2016, and with embryos originating from donated eggs it was 41.1% (41% in 2016). After ED the PR per fresh embryo transfer was 49.2% (49.4% in 2016) and per FOR 43.3% (43.6% in 2016).In IVF and ICSI together, the trend towards the transfer of fewer embryos continues with the transfer of 1, 2, 3 and ≥4 embryos in 46.0%, 49.2%, 4.5% and in 0.3% of all treatments, respectively (corresponding to 41.5%, 51.9%. 6.2% and 0.4% in 2016). This resulted in a reduced proportion of twin DRs of 14.2% (14.9% in 2016) and stable triplet DR of 0.3%. Treatments with FER in 2017 resulted in a twin and triplet DR of 11.2% and 0.2%, respectively (vs 11.9% and 0.2% in 2016).After IUI, the DRs remained similar at 8.7% after IUI-H (8.9% in 2016) and at 12.4% after IUI-D (12.4.0% in 2016). Twin and triplet DRs after IUI-H were 8.1% and 0.3%, respectively (in 2016: 8.8% and 0.3%) and 6.9% and 0.2% after IUI-D (in 2016: 7.7% and 0.4%). Amongst 18 888 FP interventions in 13 countries, cryopreservation of ejaculated sperm (n = 11 112 vs 7877 from 11 countries in 2016) and of oocytes (n = 6588 vs 4907 from eight countries in 2016) were the most frequently reported. Limitations reasons for caution: As the methods of data collection and levels of reporting vary amongst European countries, interpretation of results should remain cautious. Some countries were unable to deliver data about the number of initiated cycles and deliveries. Wider implications of the findings: The 21st ESHRE report on ART, IUI and FP interventions shows a continuous increase of reported treatment numbers and MAR-derived livebirths in Europe. Being already the largest data collection on MAR in Europe, efforts should continue to optimize data collection and reporting with the perspective of improved quality control, transparency and vigilance in the field of reproductive medicine. Study funding/competing interests: The study has received no external funding and all costs are covered by ESHRE. There are no competing interests.info:eu-repo/semantics/publishedVersio

ART in Europe, 2019 : results generated from European registries by ESHRE

Study question: What are the data and trends on ART and IUI cycle numbers and their outcomes, and on fertility preservation (FP) interventions, reported in 2019 as compared to previous years? Summary answer: The 23rd ESHRE report highlights the rising ART treatment cycles and children born, alongside a decline in twin deliveries owing to decreasing multiple embryo transfers; fresh IVF or ICSI cycles exhibited higher delivery rates, whereas frozen embryo transfers (FET) showed higher pregnancy rates (PRs), and reported IUI cycles decreased while maintaining stable outcomes. What is known already: ART aggregated data generated by national registries, clinics, or professional societies have been gathered and analyzed by the European IVF-Monitoring (EIM) Consortium since 1997 and reported in a total of 22 manuscripts published in Human Reproduction and Human Reproduction Open. Study design, size, duration: Data on medically assisted reproduction (MAR) from European countries are collected by EIM for ESHRE each year. The data on treatment cycles performed between 1 January and 31 December 2019 were provided by either national registries or registries based on initiatives of medical associations and scientific organizations or committed persons in one of the 44 countries that are members of the EIM Consortium. Participants/materials, setting, methods: Overall, 1487 clinics offering ART services in 40 countries reported, for the second time, a total of more than 1 million (1 077 813) treatment cycles, including 160 782 with IVF, 427 980 with ICSI, 335 744 with FET, 64 089 with preimplantation genetic testing (PGT), 82 373 with egg donation (ED), 546 with IVM of oocytes, and 6299 cycles with frozen oocyte replacement (FOR). A total of 1169 institutions reported data on IUI cycles using either husband/partner's semen (IUI-H; n = 147 711) or donor semen (IUI-D; n = 51 651) in 33 and 24 countries, respectively. Eighteen countries reported 24 139 interventions in pre- and post-pubertal patients for FP, including oocyte, ovarian tissue, semen, and testicular tissue banking. Main results and the role of chance: In 21 countries (21 in 2018) in which all ART clinics reported to the registry 476 760 treatment cycles were registered for a total population of approximately 300 million inhabitants, allowing the best estimate of a mean of 1581 cycles performed per million inhabitants (range: 437-3621). Among the reporting countries, for IVF the clinical PRs per aspiration slightly decreased while they remained similar per transfer compared to 2018 (21.8% and 34.6% versus 25.5% and 34.1%, respectively). In ICSI, the corresponding PRs showed similar trends compared to 2018 (20.2% and 33.5%, versus 22.5% and 32.1%) When freeze-all cycles were not considered for the calculations, the clinical PRs per aspiration were 28.5% (28.8% in 2018) and 26.2% (27.3% in 2018) for IVF and ICSI, respectively. After FET with embryos originating from own eggs, the PR per thawing was at 35.1% (versus 33.4% in 2018), and with embryos originating from donated eggs at 43.0% (41.8% in 2018). After ED, the PR per fresh embryo transfer was 50.5% (49.6% in 2018) and per FOR 44.8% (44.9% in 2018). In IVF and ICSI together, the trend toward the transfer of fewer embryos continues with the transfer of 1, 2, 3, and ≥4 embryos in 55.4%, 39.9%, 2.6%, and 0.2% of all treatments, respectively (corresponding to 50.7%, 45.1%, 3.9%, and 0.3% in 2018). This resulted in a reduced proportion of twin delivery rates (DRs) of 11.9% (12.4% in 2018) and a similar triplet DR of 0.3%. Treatments with FET in 2019 resulted in twin and triplet DR of 8.9% and 0.1%, respectively (versus 9.4% and 0.1% in 2018). After IUI, the DRs remained similar at 8.7% after IUI-H (8.8% in 2018) and at 12.1% after IUI-D (12.6% in 2018). Twin and triplet DRs after IUI-H were 8.7% and 0.4% (in 2018: 8.4% and 0.3%) and 6.2% and 0.2% after IUI-D (in 2018: 6.4% and 0.2%), respectively. Eighteen countries (16 in 2018) provided data on FP in a total number of 24 139 interventions (20 994 in 2018). Cryopreservation of ejaculated sperm (n = 11 592 versus n = 10 503 in 2018) and cryopreservation of oocytes (n = 10 784 versus n = 9123 in 2018) were most frequently reported. Limitations, reasons for caution: Caution with the interpretation of results should remain as data collection systems and completeness of reporting vary among European countries. Some countries were unable to deliver data about the number of initiated cycles and/or deliveries. Wider implications of the findings: The 23rd ESHRE data collection on ART, IUI, and FP interventions shows a continuous increase of reported treatment numbers and MAR-derived livebirths in Europe. Although it is the largest data collection on MAR in Europe, further efforts toward optimization of both the collection and the reporting, from the perspective of improving surveillance and vigilance in the field of reproductive medicine, are awaited. Study funding/competing interest(s): The study has received no external funding and all costs are covered by ESHRE. There are no competing interests. Keywords: ICSI; IUI; IVF; data collection; egg donation; fertility preservation; frozen embryo transfer; registry; surveillance; vigilance.peer-reviewe

Frozen embryo transfer:early pregnancy, perinatal outcomes, and health of singleton children

Abstract The main goal of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment is a healthy mother and a healthy child. The most important complication following IVF/ICSI arises from the increased risk of multiple pregnancies. An elective single embryo transfer (eSET) with the freezing of spare embryos and subsequent treatment with frozen embryo transfer (FET) is the only way to avoid this complication. For this reason, the number of children born after FET is steadily rising. The aim of this study was to provide more detailed evidence on the safety of FET, particularly focusing on serum hormone profiles during the first trimester weeks of singleton pregnancies after IVF/ICSI fresh embryo transfer (ET), after FET during a natural menstrual cycle, and after spontaneous conception. Another part of this study compared the perinatal outcomes, congenital anomalies (CAs), and morbidity of singletons born after FET and IVF/ICSI fresh ET. The reference group was those born after spontaneously conceived (SC) pregnancies. In the clinical prospective study, the maternal serum estradiol and progesterone levels in pregnancies after fresh ET (n=39) were higher during early pregnancy weeks than in FET (n=30) and SC pregnancies (n=41), while the hormonal profiles after FET did not differ from SC pregnancies. In the large register study, FET children (n=1830) were found to have a reduced risk for adverse perinatal outcomes, such as preterm birth, a low birthweight, and being small for their gestational age compared with children born after fresh ET (n=2942). However, FET children have an increased risk for being large for their gestational age. The major CAs and morbidity until three years of age did not differ between groups. When compared with SC children (n =31 243), the perinatal outcome was worse and the rates of CAs and morbidity were higher in FET children. The FET cycle seemed to provide a better physiological environment for early fetal development than fresh ET. Further, FET protects against some of the adverse perinatal outcomes of children when compared with fresh ET, but not when it comes to the major CAs and early somatic health. This study provides further evidence of the safety of FET in comparison with fresh ET. This information should further encourage clinicians to implement eSET combined with cryopreservation in their IVF/ICSI program.Tiivistelmä Koeputkihedelmöityshoidon (in vitro fertilization, IVF ja intracytoplasmic sperm injection, ICSI) tavoitteena on terve äiti ja terve lapsi. Monisikiöraskaus on hoidon komplikaatio, koska siihen liittyy selkeästi kohonnut riski äidille ja lapselle. Yhden alkion siirto, jäljelle jääneiden alkioiden pakastus ja myöhemmin tehtävä pakastetun alkion siirto (PAS) ovat lisänneet IVF/ICSI-hoitojen turvallisuutta ja tehokkuutta. Täten PAS:sta syntyneiden lasten määrä kasvaa. Tutkimuksen tavoitteena on lisätä PAS-hoitojen turvallisuutta tarkastelemalla veren steroidihormonien muutoksia alkuraskaudessa naisilta, jotka olivat tulleet raskaiksi IVF/ICSI-tuorealkion siirroista, luonnollisen kuukautiskierron aikana tehdystä PAS:sta ja luonnollisesti. Lisäksi tutkimuksessa verrattiin PAS- ja IVF/ICSI-tuorealkion siirrosta alkunsa saaneiden lasten terveyttä kolmeen ikävuoteen asti. Viiteryhmän muodostivat luonnollisesti alkunsa saaneet lapset. Kliinisessä prospektiivisessa tutkimuksessa havaittiin naisilla, joilla oli tuorealkion siirrosta alkanut raskaus (n=39), merkittävästi koholla olevat seerumin estradioli- ja progesteronipitoisuudet 7-8 raskausviikolle asti verrattuna naisiin, joilla raskaudet olivat alkaneet PAS:sta (n=30) tai luonnollisesti (n=41). Vastaavasti PAS-raskauksissa hormonipitoisuudet eivät eronneet merkittävästi luonnolliseen raskauteen verrattuna. Laajassa rekisteritutkimuksessa havaittiin PAS-lapsilla (n=1830) olevan pienempi riski ennenaikaisuuteen ja pienipainoisuuteen kuin tuorealkiolapsilla (n=2942). Kuitenkin PAS-lapsilla oli lisääntynyt riski syntyä isokokoisina raskausviikkoihin nähden. Synnynnäisten epämuodostumien ja eri sairauksien esiintyvyyksissä ei ollut eroja. Luonnollisesti alkunsa saaneisiin lapsiin (n= 31 243) verrattaessa, PAS-lapsilla oli vastasyntyneisyyskaudelta lähtien enemmän terveyteen liittyviä ongelmia. Tutkimus osoitti PAS-raskaudessa sikiön kehittyvän alkuviikkoina luonnollisemmassa ympäristössä kuin tuorealkion siirtoraskaudessa. Vaikka suurin osa PAS- ja tuorealkiolapsista oli terveitä, tuorealkiolapsilla oli vastasyntyneisyyskaudella enemmän ongelmia kuin PAS-lapsilla. Muita terveyseroja lasten välillä ei todettu. Tutkimus antaa lisänäyttöä PAS hoidon turvallisuudesta. Alkion pakastamisella voidaan välttää koeputkihedelmöityshoidon riskejä pyrkimällä mahdollisimman usein yhden alkion siirtoon

Childhood growth of term singletons born after frozen compared with fresh embryo transfer

Research question: Is the growth of term singletons born after frozen embryo transfer (FET) comparable to those born after fresh embryo transfer and natural conception up to 5 years of age? Design: Observational cohort study in an academic medical centre and municipal child health clinics with repeated measurements carried out by medical professionals. Term singletons born after FET (n = 110) and fresh embryo transfer (n = 181) and their matched natural conception controls (n = 543) born in Oulu, Northern Finland, were included. Mean weights, lengths, heights and head circumferences at the ages of 4, 8 and 18 months and 3 and 5 years were compared. At 3 and 5 years, body mass indices were compared. Results: Childhood growth did not differ between term singletons born after FET, fresh embryo transfer and natural conception, correcting for exact age at measurement and adjusting for maternal body mass index and paternal height. Conclusions: Similar growth between children born after FET, fresh embryo transfer and natural conception offers reassurance of the safety and feasibility of the steadily increasing use of embryo cryopreservation in assisted reproduction.Peer reviewe

Bio-energy and youth: Analyzing the role of school, home, and media from the future policy perspectives

The study investigated the relationships between students' perceived information on bio-energy from school, home and media and their perceptions, attitudes, and knowledge regarding bio-energy. The study also analyzed the scope of future policies to raise awareness among young students about bio-energy. Data drawn from 495 Finnish students studying in ninth grade revealed that the students were more positive in their attitudes towards bio-energy compared to their perceptions of it. They were very positive about learning about bio-energy, while not so eager towards its utilization. It appeared that school, home, and media all had statistically significant effects on students' perceptions, attitudes, and level of knowledge related to bio-energy. Three principal components emerged from students' perceptions and attitudes towards bio-energy viz. [`]motivation' revealing students' eagerness to know more about bio-energy; [`]considering sustainability' revealing their criticality of forest bio-energy; and [`]utilization' revealing their state of interests to use bio-energy. Bio-energy policies to be effective must consider the role of school, home, and media as important means to engage young students in bio-energy related discussions. It is also desirable to establish interactions between energy and educational policies to integrate the modern renewable energy concepts in the school curriculum.Bio-energy Youth School Home Media Policy