-
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
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
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
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
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
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
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
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
5/34
Wrojs`kr ot Nbosthdyst Ttofk
Fbumhvscy kt ob, Dhderojk ^kvikw >1?>
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
6/34
Gksifj
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
7/34
^ojghliskg, 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)
Fj^E 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)
Pitri`idotihjh` 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
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
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
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
9/34
LKFOTKW Nihlorckrs Ijvkstifotihjs
Tkrul prh`ibk
@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 prh`ibk nylidrhorroy
^kob-tilk _-QD^h` rkbkvojt fkjks
[tkrijk dhjtrodtibity
Nbosthdystlhrpehbhfy
^kbotihjseip thtrkotlkjt hutdhlk
4G lhgkbbijf h` kjghlktriul
Kjghdrijk
prh`ibk
Hhdytk thnbosthdyst
[tkrus
ojg kjgh-
lktriul
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
10/34
LKFOTKW Nihlorckrs Ijvkstifotihjs
Tkrul prh`ibk
@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 prh`ibk nylidrhorroy
^kob-tilk _-QD^h` rkbkvojt fkjks
[tkrijk dhjtrodtibity
Nbosthdystlhrpehbhfy
^kbotihjseip thtrkotlkjt hutdhlk
4G lhgkbbijf h` kjghlktriul
Kjghdrijk
prh`ibk
Hhdytk thnbosthdyst
[tkrus
ojg kjgh-
lktriul
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
11/34
Cky @ijgijfs
Qrilory hnmkdtivk
OLE
Qrhfkstkrhjk ojg trkotlkjt hutdhlk Nbosthdyst quobity ojg trkotlkjt hutdhlk
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
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?
Gkvrhky kt ob., @krtib Ttkrib >1?>
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
13/34
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
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
Gkvrhky kt ob., @krtib Ttkrib >1?>
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
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
Gkvrhky kt ob., @krtib Ttkrib >1?>
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
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
Gkvrhky kt ob., @krtib Ttkrib >1?>
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
17/34
OLE
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
18/34
OLE Is tek Nkst Qrkgidthr h` Hvorioj ^ksphjsk
OLE Nosob @TE O@D
Ordk kt ob., @krtib Ttkrib >1?4
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
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
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
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
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
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
?;
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
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
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
23/34
Qrhfkstkrhjk
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
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
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
25/34
Hjfhijf Qrkfjojdy
ny Qrhfkstkrhjk ot Kjg h` Ttilubotihj
Goto hj `ibk
p21.1;
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
26/34
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
27/34
Hjfhijf Qrkfjojdy
ny Qrhfkstkrhjk ot Kjg h` Ttilubotihj
44%
>.4 4.;
Goto hj `ibk
Ovkrofk hjfhijf prkfjojdy
rotk pkr dydbk wite trojs`kr
p21.1;
JT
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
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
J
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
29/34
Hjfhijf Qrkfjojdy
ny Qrhfkstkrhjk ot Kjg h` Ttilubotihj
>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
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
(%)
Qrhfkstkrhjk ot kjg h` stilubotihj
EQ-eLFr@TE
?.>0 jf/lB < 7 jlhb/B
?.60 jf/lB < ;.0 jlhb/B
Goto hj `ibk
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
30/34
Nbosthdyst _uobity
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
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
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
32/34
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
33/34
Dhjdbusihjs
-
8/12/2019 Joan Carles Arce - New Insights Into Single Embryo Transfer Evidencis With hMG-HP - II Simposio Reproduccin Asistida Quirn
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 Fj^E 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 prh`ibk 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 spkdi`id rhbk h` kode
nbosthdyst lhrpehbhfy porolktkr hj trkotlkjt hutdhlk.