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Wennerholm UB, Henningsen AKA, Romundstad LB, Bergh C, Pinborg A, Skjaerven R, Forman J, Gissler M, Nygren KG, Tiitinen A. Perinatal outcomes of children born after frozen-thawed embryo transfer: a Nordic cohort study from the CoNARTaS group. Hum Reprod 2013; 28:2545-53. [DOI: 10.1093/humrep/det272] [Citation(s) in RCA: 254] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Dain L, Bider D, Levron J, Zinchenko V, Westler S, Dirnfeld M, Di Emidio G, Falone S, Vitti M, Santonocito M, Vento M, Artini PG, Di Pietro C, Amicarelli F, Tatone C, Herreboudt A, Colledge WH, Anastacio A, Pionneau C, Chardonnet S, Santos TA, Poirot C, Bensdorp AJ, Tjon-Kon-Fat RI, Koks C, Oosterhuis GJE, Hoek A, Hompes PGA, Broekmans FJ, Verhoeve HR, de Bruin JP, van Golde R, Repping S, Cohlen BJ, Mol BWJ, van der FV, van MW, Henningsen AA, Gissler M, Nygren KG, Skjaerven R, Tiitinen A, Wennerholm UB, Romundstad LB, Andersen AN, Lidegaard O, Forman JL, Pinborg A. Session 07: Female infertility: new developments. Hum Reprod 2013. [DOI: 10.1093/humrep/det229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Stora C, Devouche E, Delaroche L, Patrat C, Matheron S, Damond F, Yazbeck C, Longuet P, Llabador MA, Luton D, Epelboin S, Lemmen J, Rasmussen S, Ziebe S, El Khattabi L, Hafhouf E, Royere D, Pouly JL, De Mouzon J, Levy R, Hagman A, Loft A, Wennerholm UB, Pinborg A, Bergh C, Aittomaki K, Nygren KG, Romundstad LB, Hazekamp J, Soderstrom-Anttila V, Mukaida T, Goto T, Tajima T, Oka C, Takahashi K, Carrasco B, Boada M, Rodriguez I, Coroleu B, Barri PN, Veiga A, Wennerholm UB, Henningsen AKA, Romundstad LB, Bergh C, Pinborg A, Skjaerven R, Forman J, Gissler M, Nygren KG, Tiitinen A. Session 60: Perinatal outcome after ART. Hum Reprod 2013. [DOI: 10.1093/humrep/det193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sullivan E, Hilder L, Wang YA, Sundh KJ, Bergh C, Henningsen AKA, Kallen K, Romundstad LB, Pinborg A, Nyboe-Andersen A, Skjaerven R, Gissler M, Tiitinen A, Nygren KG, Wennerholm UB, Williams CL, Bunch KJK, Stiller CA, Murphy MFG, Wallce WH, Davies M, Botting B, Sutcliffe AG, Cesta CE, Olsson H, Cnattingius S, Nygren KG, Johansson V, Lichtenstein P, Iliadou AN, Gameiro S, van den Belt-Dusebout AW, Bleiker E, Braat D, van Leeuwen FE, Verhaak CM. Session 44: Long term outcome of ART. Hum Reprod 2013. [DOI: 10.1093/humrep/det177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Vuori-Holopainen E, Mäkipernaa A, Tiitinen A. [Menorrhagia in adolescents: normal or a sign of underlying medical condition?]. DUODECIM; LAAKETIETEELLINEN AIKAKAUSKIRJA 2013; 129:2613-2620. [PMID: 24471204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Variations in the length of menstrual cycle as well as duration of menstrual flow are broad and common during adolescence. They are mainly caused by the immaturity of the hypothalamic-pituitary-ovarian axis. Normalization of ovulation during the first postmenarcheal years will gradually regularize the menstrual cycle. Several medical conditions, endocrine disturbances or medical treatments may affect the hormonal balance and cause abnormal bleeding. If anemia exists, the possibility of bleeding disorder should be considered. After proper evaluation, most abnormal bleedings in adolescents can be managed hormonally, with the addition of hemostatic therapies when necessary. Oral contraceptives are most commonly used.
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Wennerholm UB, Henningsen AK, Romundstad LB, Skjaerven R, Nygren KG, Gissler M, Tiitinen A, Pinborg A. 30: Perinatal outcome in singletons born after replacement of frozen/thawed embryos. Am J Obstet Gynecol 2013. [DOI: 10.1016/j.ajog.2012.10.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tiitinen A. Prevention of multiple pregnancies in infertility treatment. Best Pract Res Clin Obstet Gynaecol 2012; 26:829-40. [DOI: 10.1016/j.bpobgyn.2012.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 04/23/2012] [Accepted: 05/13/2012] [Indexed: 11/17/2022]
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Ohman H, Bailey R, Natividad A, Ragoussis J, Johnson LL, Tiitinen A, Halttunen M, Paavonen J, Surcel HM. Effect of IL12A and IL12B polymorphisms on the risk of Chlamydia trachomatis-induced tubal factor infertility and disease severity. Hum Reprod 2012; 27:2217-23. [PMID: 22581790 DOI: 10.1093/humrep/des136] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Interleukin-12 (IL-12) and related cytokines induce activation and differentiation of T cells. Our aim was to investigate the associations between genetic differences in IL-12-family cytokines and the pathogenesis of chlamydial disease. METHODS The final study population consisted of 100 women with Chlamydia trachomatis-induced tubal factor infertility (TFI) and 125 pregnant women as controls. Three single nucleotide polymorphisms (SNPs) of IL12A and seven SNPs of IL12B genes were determined from isolated DNA using the Sequenom system with matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry. RESULTS We found that the IL12B SNP rs3212227 was associated with both susceptibility and severity of TFI. The minor allele C was rare and only one CC homozygote was found among the controls. AC heterozygotes were more common among TFI cases than among controls (P = 0.009) and were associated with increased risk of TFI [odds ratios (OR) = 2.44, 95% confidence intervals (CI) = 1.23-4.87]. Carrying the minor allele C was also associated with disease severity (P for trend = 0.008) and moderate (OR = 2.51, 95% CI = 1.06-5.95) and severe tubal damage (OR = 2.73, 95% CI = 1.15-6.52). CONCLUSIONS The results suggest that variation in the IL12B gene partly explains inter-individual differences in disease susceptibility and severity.
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Morin-Papunen L, Rantala AS, Unkila-Kallio L, Tiitinen A, Hippeläinen M, Perheentupa A, Tinkanen H, Bloigu R, Puukka K, Ruokonen A, Tapanainen JS. Metformin improves pregnancy and live-birth rates in women with polycystic ovary syndrome (PCOS): a multicenter, double-blind, placebo-controlled randomized trial. J Clin Endocrinol Metab 2012; 97:1492-500. [PMID: 22419702 DOI: 10.1210/jc.2011-3061] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The role of metformin in the treatment of infertility in women with polycystic ovary syndrome (PCOS) is still controversial. OBJECTIVE AND OUTCOMES: We investigated whether metformin decreases the early miscarriage rate and improves the pregnancy rates (PR) and live-birth rates (LBR) in PCOS. METHODS This was a multicenter, randomized (1:1), double-blind, placebo-controlled study. Three hundred twenty women with PCOS and anovulatory infertility were randomized to metformin (n = 160, Diformin; obese women, 1000 mg two times daily; nonobese subjects, 500 mg + 1000 mg daily) or identical doses of placebo (n = 160). After 3 months' treatment, another appropriate infertility treatment was combined if necessary. If pregnancy occurred, metformin/placebo was continued up to the 12th week. RESULTS Miscarriage rates were low and similar in the two groups (metformin 15.2% vs. placebo 17.9%, P = 0.8). Intent-to-treat analysis showed that metformin significantly improved PR and LBR (vs. placebo) in the whole study population (PR: 53.6 vs. 40.4%, P = 0.006; LBR: 41.9 vs. 28.8%, P = 0.014) and PR in obese women (49.0 vs. 31.4%, P = 0.04), and there was a similar trend in nonobese (PR: 58.6 vs. 47.6%, P = 0.09; LBR: 46.7 vs. 34.5%, P = 0.09) and in obese women with regard to LBR (35.7 vs. 21.9%, P = 0.07). Cox regression analysis showed that metformin plus standard infertility treatment increased the chance of pregnancy 1.6 times (hazard rate 1.6, 95% confidence interval 1.13-2.27). CONCLUSION Obese women especially seem to benefit from 3 months' pretreatment with metformin and its combination thereafter with routine ovulation induction in anovulatory infertility.
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Koskela-Koivisto T, Juuti A, Tiitinen A. [Bariatric surgery and reproductive health]. DUODECIM; LAAKETIETEELLINEN AIKAKAUSKIRJA 2012; 128:259-265. [PMID: 22428379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Obesity is associated with metabolic complications such as insulin-resistance, type 2 diabetes, dyslipidemia, hypertension and polycystic ovary syndrome. Obesity adversely impacts fecundability and IVF outcomes through a variety of mechanisms, however even modest weight loss can improve situation. Pregnancy may be a significant health risk for morbidly obese women (BMI over 40 kg/m2) and fertility treatments are not recommended before weight loss. The fertile age of women is limited, therefore an efficient treatment of obesity should be chosen. For morbid obesity bariatric surgery combined with lifestyle changes is more efficient treatment than conservative treatment alone. Weight loss is associated with significant improvement in many parameters of reproductive function, chance to get pregnant improves and gestational risks decrease.
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Vänskä M, Punamäki RL, Tolvanen A, Lindblom J, Flykt M, Unkila-Kallio L, Tiitinen A, Repokari L, Sinkkonen J, Tulppala M. Maternal pre- and postnatal mental health trajectories and child mental health and development. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2011. [DOI: 10.1177/0165025411417505] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Pregnancy and early motherhood involve uncertainty and change, which can evoke mental health problems. We identified maternal mental health trajectories in pre- and postnatal period, and examined their association with later child mental health and development. Finnish mothers reported psychological distress (General Health Questionnaire [GHQ-36]) and depressive (Beck Depression Inventory [BDI-13]) symptoms in pregnancy (T1; N = 788) and two months (T2; N = 657) and 12 months (T3; N = 545) postpartum. Both parents accounted their child’s mental health (Behavior Assessment System for Children [BASC]) and social (Social Skills Rating System [SSRS], Child Behavior Scale [CBS]) and cognitive development (Five to Fifteen [FTF]) when the child was 7–8 years old (T4; N = 485). We identified five trajectories depicting unique timing and course of maternal mental health from pregnancy into 1 year of mothering: Stable low levels of mental health symptoms (75%) and prenatal (6%), early postpartum (9%) and late postpartum (6%) mental health problems. The fifth trajectory, heterogeneous high levels of mental health problems (4%) was an unclassified post hoc class, combining mothers with chronic high or highly variable mental health profiles. Results show some trajectory-related timing effects on children’s mental health and cognitive development. The trajectories of early postpartum and heterogeneous high levels of mental health problems predicted higher level of internalizing symptoms as compared to stable low-levels trajectory. The heterogeneous high-levels trajectory predicted higher levels of problems in executive functions than the stable low and late postpartum trajectories, and in memory tasks than children in other trajectories. We discuss the timing and course of maternal mental health from the viewpoint of infant and child development.
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Vihma V, Koskela A, Turpeinen U, Hämäläinen E, Tiitinen A, Wähälä K, Tikkanen MJ, Adlercreutz H. Are there endogenous estrone fatty acyl esters in human plasma or ovarian follicular fluid? J Steroid Biochem Mol Biol 2011; 127:390-5. [PMID: 21708250 DOI: 10.1016/j.jsbmb.2011.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 06/08/2011] [Accepted: 06/10/2011] [Indexed: 01/11/2023]
Abstract
BACKGROUND Estrone and its sulfated esters are the most abundant estrogens in blood in men and in women after the menopause. However, previous studies on the esterification of estrone with fatty acids have yielded conflicting results, some studies reporting high nanomolar concentrations of estrone fatty acyl esters in plasma. METHODS We developed an estrone radioimmunoassay (RIA) method to determine endogenous concentrations of estrone and after saponification, applied it to male and female plasma. In addition, the concentration of estrone fatty acyl esters in ovarian follicular fluid was analyzed by gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-tandem mass spectrometry (LC-MS/MS). RESULTS By estrone RIA, we did not find measurable amounts of estrone fatty acyl esters in male or female plasma, except for one premenopausal woman who had the highest plasma concentration of nonesterified estrone. The concentration of hydrolyzed estrone fatty acyl esters determined by LC-MS/MS in follicular fluid obtained from women undergoing ovarian stimulation was below the limit of quantification of <10 pmol/l (<2.7 ng/l). CONCLUSIONS In contrast to previous data by others, our study suggests that estrone fatty acyl esters are in most cases not detectable in plasma of healthy men or healthy nonpregnant women.
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Flykt M, Lindblom J, Punamäki RL, Poikkeus P, Repokari L, Unkila-Kallio L, Vilska S, Sinkkonen J, Tiitinen A, Almqvist F, Tulppala M. Prenatal expectations in transition to parenthood: Former infertility and family dynamic considerations. ACTA ACUST UNITED AC 2011. [DOI: 10.1037/2160-4096.1.s.31] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Tarkkila L, Furuholm J, Tiitinen A, Meurman JH. Saliva in perimenopausal and early postmenopausal women. A 2-year follow-up study. Clin Oral Investig 2011; 16:767-73. [PMID: 21637984 DOI: 10.1007/s00784-011-0573-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2010] [Accepted: 05/25/2011] [Indexed: 11/29/2022]
Abstract
This study aims to investigate salivary flow and biochemical constituents of menopausal-age women with the hypothesis that women using hormone therapy (HT) might present better saliva values than non-users. Two hundred HT users and 200 non-users were selected at random from a cohort study of 3,173 peri- and postmenopausal women and invited to a 2-year clinical follow-up study. Clinical examination with saliva sampling was made at baseline and 2 years later. Salivary total protein, albumin, and immunoglobulin (Ig) concentrations were analyzed. Final material included 106 consistent HT users and 55 non-users. Backward logistic regression analysis was made to determine the risk factors for higher or lower than medium salivary protein values. No difference was seen in salivary flow rate, total protein, and IgA values between baseline and follow-up measurements or between the groups. Albumin, IgG, and IgM concentrations were significantly lower in the 2-year samples of the HT group when compared with baseline. IgA and IgM values were higher in the non-HT 2-year samples when compared with the corresponding HT samples. The only significant explanatory factor for higher than median salivary albumin concentration was the number of teeth both at baseline and 2 years later. HT possibly improved epithelial integrity since the concentrations of serum components albumin, IgG, and IgM decreased during the follow-up. HT as such does not seem to affect saliva, although it may modify it. The clinical relevance of these results needs to be assessed in future studies.
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Alfthan H, Björses UM, Tiitinen A, Stenman UH. Specificity and Detection Limit of Ten Pregnancy Tests. Scandinavian Journal of Clinical and Laboratory Investigation 2011. [DOI: 10.1080/00365519309086911] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Öhman H, Tiitinen A, Halttunen M, Paavonen J, Surcel HM. Cytokine gene polymorphism and Chlamydia trachomatis-specific immune responses. Hum Immunol 2011; 72:278-82. [DOI: 10.1016/j.humimm.2010.12.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 11/30/2010] [Accepted: 12/27/2010] [Indexed: 10/18/2022]
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Broeze K, Opmeer B, Coppus S, Van Geloven N, Alves M, Ånestad G, Bhattacharya S, Allan J, Guerra-Infante M, Den Hartog J, Land J, Idahl A, Van der Linden P, Mouton J, Ng E, Van der Steeg J, Steures P, Svenstrup H, Tiitinen A, Toye B, Van der Veen F, Mol B. Chlamydia antibody testing and diagnosing tubal pathology in subfertile women: an individual patient data meta-analysis. Hum Reprod Update 2011; 17:301-10. [DOI: 10.1093/humupd/dmq060] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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Wang YA, Sullivan EA, Sullivan EA, Wang YA, Abeywardana S, Kovacs G, Henningsen AA, Wennerholm UB, Gissler M, Skjaerven R, Nyboe Andersen A, Nygren KG, Tiitinen A, Romundstad LB, Forman JL, Pinborg A, Fulford B, Bunting L, Tsibulsky I, Boivin J, Connolly M, Postma MJ, Crespi S, Nyboe Andersen A, Ziebe S, Druckenmiller S, Knopman JM, DeVore S, Krey L, Noyes N, Privitera L, Remohi J, Morgan M, Pellicer A, Garrido N. SELECTED ORAL COMMUNICATION SESSION, SESSION 73: EPIDEMIOLOGY & HEALTH ECONOMICS Wednesday 6 July 2011 14:00 - 15:45. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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McLernon DJ, Harrild K, Bergh C, Davies MJ, de Neubourg D, Dumoulin JCM, Gerris J, Kremer JAM, Martikainen H, Mol BW, Norman RJ, Thurin-Kjellberg A, Tiitinen A, van Montfoort APA, van Peperstraten AM, Van Royen E, Bhattacharya S. Clinical effectiveness of elective single versus double embryo transfer: meta-analysis of individual patient data from randomised trials. BMJ 2010; 341:c6945. [PMID: 21177530 PMCID: PMC3006495 DOI: 10.1136/bmj.c6945] [Citation(s) in RCA: 228] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/29/2010] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To compare the effectiveness of elective single embryo transfer versus double embryo transfer on the outcomes of live birth, multiple live birth, miscarriage, preterm birth, term singleton birth, and low birth weight after fresh embryo transfer, and on the outcomes of cumulative live birth and multiple live birth after fresh and frozen embryo transfers. DESIGN One stage meta-analysis of individual patient data. DATA SOURCES A systematic review of English and non-English articles from Medline, Embase, and the Cochrane Central Register of Controlled Trials (up to 2008). Additional studies were identified by contact with clinical experts and searches of bibliographies of all relevant primary articles. Search terms included embryo transfer, randomised controlled trial, controlled clinical trial, single embryo transfer, and double embryo transfer. Review methods Comparisons of the clinical effectiveness of cleavage stage (day 2 or 3) elective single versus double embryo transfer after fresh or frozen in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) treatments were included. Trials were included if the intervention differed only in terms of the intended number of embryos to be transferred. Trials that involved only blastocyst (day five) transfers were excluded. RESULTS Individual patient data were received for every patient recruited to all eight eligible trials (n=1367). A total of 683 and 684 women randomised to the single and double embryo transfer arms, respectively, were included in the analysis. Baseline characteristics in the two groups were comparable. The overall live birth rate in a fresh IVF cycle was lower after single (181/683, 27%) than double embryo transfer (285/683, 42%) (adjusted odds ratio 0.50, 95% confidence interval 0.39 to 0.63), as was the multiple birth rate (3/181 (2%) v 84/285 (29%)) (0.04, 0.01 to 0.12). An additional frozen single embryo transfer, however, resulted in a cumulative live birth rate not significantly lower than the rate after one fresh double embryo transfer (132/350 (38%) v 149/353 (42%) (0.85, 0.62 to 1.15), with a minimal cumulative risk of multiple birth (1/132 (1%) v 47/149 (32%)). The odds of a term singleton birth (that is, over 37 weeks) after elective single embryo transfer was almost five times higher than the odds after double embryo transfer (4.93, 2.98 to 8.18). CONCLUSIONS Elective single embryo transfer results in a higher chance of delivering a term singleton live birth compared with double embryo transfer. Although this strategy yields a lower pregnancy rate than a double embryo transfer in a fresh IVF cycle, this difference is almost completely overcome by an additional frozen single embryo transfer cycle. The multiple pregnancy rate after elective single embryo transfer is comparable with that observed in spontaneous pregnancies.
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Tuuri A, Tiitinen A, Hiilesmaa V, Hämäläinen E, Turpeinen U, Tikkanen MJ, Kaaja R. Hormonal and metabolic characteristics of premenopausal women with a history of preeclamptic pregnancy. Acta Obstet Gynecol Scand 2010; 89:1331-7. [PMID: 20846066 DOI: 10.3109/00016349.2010.505638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate whether women with a history of preeclampsia have more signs of hyperandrogenism and insulin resistance in the premenopausal period than women with history of normotensive pregnancies. DESIGN Case-control study. SETTING University Hospital. SAMPLE Eighteen women with a history of preeclamptic first pregnancy and 19 women with prior normotensive first pregnancy studied 23-24 years after delivery. METHODS Diagnosis of metabolic syndrome was based on the International Diabetes Federation (IDF) criteria. Matsuda's whole-body insulin sensitivity index, serum concentrations of follicle-stimulating hormone (FSH), sex hormone-binding globulin, and total and free calculated testosterone were assessed. Polycystic ovary syndrome (PCOS) phenotype was defined using Rotterdam criteria. MAIN OUTCOME MEASURES Insulin sensitivity, metabolic syndrome and signs of hyperandrogenism. RESULTS Insulin sensitivity and total and free testosterone were similar in the two groups. However, in women with prior preeclampsia and FSH below the median, calculated free testosterone levels were higher than in women with prior preeclampsia and FSH above the median (median 13.4 range (8.0-22.5) vs. 7.1 (5.1-20.5), p = 0.03). Of the women with previous preeclampsia, 17% (3/18) had metabolic syndrome and 11% (2/18) PCOS, versus 11% (2/19) and 0% of the controls, respectively. CONCLUSIONS In women with prior preeclampsia, premenopause was not associated with insulin resistance, but signs of hyperandrogenism were present if FSH was within a premenopausal level.
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Härkki P, Tiitinen A, Ylikorkala O. Endometriosis and assisted reproduction techniques. Ann N Y Acad Sci 2010; 1205:207-13. [DOI: 10.1111/j.1749-6632.2010.05656.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tso LO, Costello MF, Andriolo RB, Albuquerque LE, Freitas V, Morin - Papunen L, Rantala A, Unkila-Kallio L, Tiitinen A, Hippelainen M, Tinkanen H, Perheentupa A, Ruokonen A, Tapanainen JS, Tang T, Barth JH, Balen AH, Lee K, Choi YS, Yang H, Seo SK, Kim HY, Lee BS, Germeyer A, Jauckus J, Zorn M, Toth B, Capp E, Strowitzki T. Session 45: PCOS1. Hum Reprod 2010. [DOI: 10.1093/humrep/de.25.s1.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tarkkila L, Kari K, Furuholm J, Tiitinen A, Meurman JH. Periodontal disease-associated micro-organisms in peri-menopausal and post-menopausal women using or not using hormone replacement therapy. A two-year follow-up study. BMC Oral Health 2010; 10:10. [PMID: 20429938 PMCID: PMC2867770 DOI: 10.1186/1472-6831-10-10] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2009] [Accepted: 04/29/2010] [Indexed: 11/25/2022] Open
Abstract
Background Despite conflicting results on the use of hormone replacement therapy (HRT) there is no doubt that many women benefit from it. Women using HRT are known to be more health conscious in general with putative positive implications in the mouth. However, we observed recently in our cohort hardly any difference in oral health status between HRT-users and non-users. There are only a few studies about HRT and oral microbiota. We hypothesized that counts of periodontal micro-organisms are lower in health-conscious HRT-users than non-users. Methods Two-year open follow-up study was conducted on originally 200 HRT-users and 200 non-users from age cohorts of 50-58 years. After clinical examination pooled subgingival plaque samples were taken for polymerase chain reaction analyses. The results of finally 135 women meeting the inclusion criteria were analyzed with cross-tabulation and chi-square test. Explanatory factors were studied by step-wise logistic regression analysis. Results In HRT group, the numbers of positive samples for Porphyromonas gingivalis (P. gingivalis, p < 0.07), Prevotella intermedia (P. intermedia, p < 0.05)and Tannerella forsythia (T. forsythia, p < 0.01) decreased in women with ≥ 4-mm-deep pockets. Respectively in HRT users with ≥ 6-mm-deep pockets the numbers of positive samples for P. gingivalis (p < 0.05) and T. forsythia (p < 0.01) were decreased. No corresponding differences were observed in the non-HRT group. In logistic regression, the existence of deep periodontal pockets explained the majority of cases harboring specific micro-organisms in both groups. Conclusion Although use of HRT did not correlate with periodontal health status, HRT led to decreasing numbers of positive samples of the periodontal pathogens P. gingivalis and T. forsythia. Further studies with longer observation time are needed to observe the clinical relevance of the results.
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Pelkonen S, Koivunen R, Gissler M, Nuojua-Huttunen S, Suikkari AM, Hydén-Granskog C, Martikainen H, Tiitinen A, Hartikainen AL. Perinatal outcome of children born after frozen and fresh embryo transfer: the Finnish cohort study 1995–2006. Hum Reprod 2010; 25:914-23. [DOI: 10.1093/humrep/dep477] [Citation(s) in RCA: 212] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Leidenius M, Tasmuth T, Jahkola T, Saarto T, Utriainen M, Vaalavirta L, Tiitinen A, Idman I. [Long-term morbidity caused by breast cancer therapy]. DUODECIM; LAAKETIETEELLINEN AIKAKAUSKIRJA 2010; 126:1217-1225. [PMID: 20597351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
All forms of breast cancer therapies are associated with both acute adverse effects and manifold long-term morbidity. Due to the common occurrence and favorable prognosis of breast cancer, the number of those suffering from complications worsening the quality of life is considerable. In a significant proportion, the long-term adverse effects caused by the therapy can be alleviated. The importance of follow-up visits of a breast cancer patient is not limited to diagnosing or excluding of relapses. During these visits, the elucidation of long-term adverse effects and their treatment alternatives and even discussing the symptoms and supporting the patient are important with respect to the quality of life.
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