Outcome of monochorionic twins conceived by assisted reproduction

Abstract

Objective: To evaluate monochorionic twins conceived by assisted reproductive technology (ART). Design: We compared perinatal outcomes of monochorionic twins conceived by ART with their dichorionic counterparts and with spontaneous monochorionic twins. Setting: Referral center. Patient(s): Mothers to monochorionic and dichorionic twins conceived by ART and spontaneous monochorionic twins. Intervention(s): None. Main Outcome Measure(s): Maternal characteristics, pregnancy complications, and perinatal outcomes. Result(s): Monochorionic twin pregnancies (n ¼ 25) comprise 7.2% of all ART twins and 4.9% of all monochorionic twins in this data set. Monochorionic pairs have a significantly worse outcome compared with dichorionic sets in terms of lower gestational age and birth weight. ART appears to increase the already high risk of monochorionicity compared with spontaneous conception: odds ratio (OR), 2.9 (1.1-7.3) for preterm birth at <32 weeks and OR, 5.9 (2.5-1.49) for birth weight <1,500 g.

Risk of adverse pregnancy and perinatal outcomes after high technology infertility treatment: a comprehensive systematic review

“…Furthermore, ART monochorionic twins are also at increased risk of adverse perinatal outcomes compared with spontaneous monochorionic twins. In fact, in monochorionicity ART appears to increase the already high risk of PTB <32 weeks (OR 2.9, 95 % CI 1.1 to 7.3) and VLBW (OR 5.9, 95 % CI 2.5 to 1.49) [26]. …”

Re-Thinking Elective Single Embryo Transfer: Increased Risk of Monochorionic Twinning - A Systematic Review

“…Rising rates of multifetal gestations are associated with ART and also with increasing maternal age at delivery [19][20][21][22][23] . The multiple birth rate increased to 71 per 1,000 live births for maternal age over 40 at conception compared to 16.3 per 1,000 at age 20.…”

“…Often, this is due to other inherent morbidities experienced by MCDA twins, such as IUGR and preeclampsia [59] . Simoes et al [60] studied fetal outcomes of twin gestations based on chorionicity only in ART mothers and found that MCDA twins conceived by ART were significantly more likely to be delivered preterm and to have lower birth weights. The higher prematurity rates also led to an increased early neonatal death rate in MCDA twins.…”

Multiple gestation: more research challenges to come

“…This study was aimed to double-check the findings of Simoes et al [10] who found that MC twins after assisted reproductive techniques (ART) are at increased risk of adverse perinatal outcomes compared with spontaneous MC twins and with DC twins conceived by ART. However, the population-based study performed by Trojner Bregar and her colleagues [11] …”

“…This study was aimed to double-check the findings of Simoes et al [10] who found that MC twins after assisted reproductive techniques (ART) are at increased risk of adverse perinatal outcomes compared with spontaneous MC twins and with DC twins conceived by ART. However, the population-based study performed by Trojner Bregar and her colleagues [11] disagreed with the hospital-based results of Simoes et al [10] and suggested that MC twins following ART have similar perinatal outcomes compared to spontaneous MC twins as well as to DC twins conceived by ART.…”