title: Improved neonatal prognosis following restriction in the number of transferred embryos in assisted reproduction - single center yearly comparison from Turkey.
abstract: OBJECTIVE
  To evaluate the impact of new legislation for assisted reproductive technology (ART) restricting the number of transferred embryos on neonatal prognosis of infants born after infertility treatments.
  
  
  METHODS
  Neonatal records of all live born infants in Ege University Maternity Ward were reviewed for 2006 and 2012. Neonatal outcome measures such as birth weight (BW), gestational age (GA), preterm birth (PTB), very low birth weight (VLBW), and neonatal intensive care unit (NICU) admission were evaluated.
  
  
  RESULTS
  Compared to 2006 percentage of newborns conceived by medically assisted reproduction (MAR) decreased from 14.6% to 5% in all live births, from 23.8% to 8.2% in NICU patients in 2012. The number of fetuses in the last pregnancy, frequency of intrauterine reductions, spontaneous pregnancy losses, antenatal bleeding, and premature delivery decreased. Percentage of multiples among MAR newborns (31.7% vs. 55.7%), twins from 51.4% to 30.9%, triplets from 4.3% to 0.8% all decreased significantly. Mean BW and gestational age increased resulting in decreased frequency of PTB and VLBW. Consequently Level 3 NICU admission rate significantly decreased from 44.3% to 22%.
  
  
  CONCLUSIONS
  The new ART legislation in Turkey resulted in decreased rate of multiple births, prematurity and related complications, and NICU admissions in MAR newborns. However the twin rates are still high. Since uncontrolled ovulation stimulation and intrauterine insemination techniques are also associated with multiple births and unfavorable neonatal outcomes, these procedures deserve close monitorization.
authors.forename: N
authors.initials: N
authors.lastname: Kultursay
authors.forename: O A
authors.initials: OA
authors.lastname: Koroglu
authors.forename: O
authors.initials: O
authors.lastname: Uygur
authors.forename: D
authors.initials: D
authors.lastname: Terek
authors.forename: S
authors.initials: S
authors.lastname: Tanriverdi
authors.forename: M
authors.initials: M
authors.lastname: Akisu
authors.forename: M
authors.initials: M
authors.lastname: Yalaz
mesh_terms: D000328:Adult; D001724:Birth Weight; D004624:Embryo Transfer / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data*; D027724:Reproductive Techniques, Assisted / Q000331:legislation & jurisprudence; D014421:Turkey / Q000453:epidemiology