Outcome of ICSI pregnancies with spontaneous loss of a co‐twin compared with singleton ICSI pregnancies: Single center experience

Abstract

Aim To compare the outcome of intracytoplasmic sperm injection (ICSI) pregnancies complicated by spontaneous loss of a dichorionic co‐twin with that of singleton ICSI pregnancies. Methods The study group included dichorionic ICSI pregnancies with co‐twin loss (n = 33) and the control group included ICSI pregnancies with a singleton from the beginning (n = 327). Primary outcome measures were obstetric complications, including preterm delivery, newborn small for gestational age, gestational diabetes, gestational hypertensive disorders and abruptio placenta; admission to neonatal intensive care unit (NICU) and perinatal mortality observed in the study and control groups. Statistical analysis was performed using spss for Windows, version 22.0. Results In the study group, there were 26 cases of first trimester (early) and 7 cases of second or third trimester (late) co‐twin losses. Mean gestational age at delivery and mean birth weight were significantly lower in the whole study group compared to control (P < 0.05). Preterm delivery and NICU admission rates were significantly higher in the whole study group, compared to control (39.3% vs 14.6% and 36.36% vs 11.69% respectively, P < 0.05), but did not show significant difference between early loss subgroup and control (P > 0.05). Preterm delivery rate was significantly higher in the late loss subgroup compared to the early loss subgroup (85.71% vs 26.92% P < 0.05). Conclusion Loss of a co‐twin in dichorionic ICSI pregnancies is associated with increased risk of preterm birth. This risk is significantly higher in cases with late loss compared to the early loss cases.

Dizygotic Twin Infants: Controversial Case Study Series/Twin Research Reviews: Twin and Non-twin ICSI Conceptions; Emory University Twin Study; Labor in Multiple Pregnancy After Previous C-Section Delivery; Cell-Free DNA Fetal Fraction in Twin Pregnancies/News Reports: Twin Survivor of Auschwitz; Twins Trading Places; Identical Twin Foals; Twins Born in Different Decades; Twins Ambulette Service

“…Twin and Non-twin intracytoplasmic sperm injection Conceptions It has been estimated that couples using intracytoplasmic sperm injection (ICSI) to overcome infertility have a 30−35% chance of conceiving twins and a 5−10% chance of conceiving triplets or more (Attain Fertility, 2019). Turkish researchers Uysal et al (2020) compared the outcomes of non-twin ICSI pregnancies and twin pregnancies with spontaneous co-twin loss. They point out that multiple pregnancies pose well-known risks to newborns, including prematurity and low birth weight.…”

“…They also note that cotwin loss occurs in approximately 30% of twin pregnancies diagnosed early in the first trimester. Uysal et al (2020) contrasted the outcomes of 33 ICSIconceived dichorionic twin pregnancies and 327 ICSI-conceived singleton pregnancies. Among the study group, co-twin loss occurred during the first trimester in 26 cases, during the second trimester in 4 cases and during the third trimester in 3 cases.…”