Monochorionic twins after in‐vitro fertilization: do they have poorer outcomes?
- 10 November 2020
- journal article
- research article
- Published by Wiley in Ultrasound in Obstetrics & Gynecology
- Vol. 56 (6), 831-836
- https://doi.org/10.1002/uog.21973
Abstract
Objective To compare the outcome of monochorionic diamniotic (MCDA) twin pregnancies conceived by in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) with that of spontaneously conceived MCDA twins. Methods This was a retrospective cohort study of MCDA twin pregnancies conceived after IVF/ICSI or spontaneously, followed from the first trimester onwards at a single center between January 2002 and September 2018. The primary outcome was survival per fetus from the first trimester until 28 days after birth. Secondary outcome measures were number of survivors, miscarriage, termination of pregnancy, intrauterine and neonatal death, major congenital anomalies, twin-twin transfusion syndrome, selective fetal growth restriction, gestational age at birth, delivery before 32 weeks' gestation, mode of delivery, admission to the neonatal intensive care unit, birth weight and birth-weight discordance. Results Of the 654 MCDA pregnancies included in the analysis, 80 were conceived by IVF/ICSI and 574 spontaneously. Overall fetal and neonatal survival was significantly lower in the IVF/ICSI group than in the spontaneous-conception group (79% vs 90%; P = 0.001). In the IVF/ICSI group, compared with the spontaneous-conception group, loss of one or both twins occurred twice as often (29% vs 14%; P = 0.001) and there was a higher risk of second-trimester miscarriage (8% vs 1%; P = 0.002). Conclusions MCDA twins conceived after IVF/ICSI have lower overall survival rates and higher rates of second-trimester miscarriage than do spontaneously conceived MCDA twins. Copyright (c) 2020 ISUOG. Published by John Wiley & Sons Ltd.Keywords
Funding Information
- Engineering and Physical Sciences Research Council
- Fifth Framework Programme (QLG1‐CT‐2002‐01632 EuroTwin2Twin)
- Fonds Wetenschappelijk Onderzoek (1804718N)
- Great Ormond Street Hospital Charity
- Wellcome
This publication has 36 references indexed in Scilit:
- Contribution of Method of Conception on Pregnancy Outcome after the 11–13 Weeks ScanFetal Diagnosis and Therapy, 2011
- Monozygotic twinning is not increased after single blastocyst transfer compared with single cleavage-stage embryo transferFertility and Sterility, 2010
- Reference ranges for middle cerebral artery peak systolic velocity in monochorionic diamniotic twins: a longitudinal studyUltrasound in Obstetrics & Gynecology, 2009
- The pregnancy and long-term neurodevelopmental outcome of monochorionic diamniotic twin gestations: a multicenter prospective cohort study from the first trimester onwardAmerican Journal of Obstetrics and Gynecology, 2009
- Ultrasound prediction of intertwin birth weight discordance in monochorionic diamniotic twin pregnanciesPrenatal Diagnosis, 2009
- The outcome of monochorionic diamniotic twin gestations in the era of invasive fetal therapy: a prospective cohort studyAmerican Journal of Obstetrics and Gynecology, 2008
- Clinical outcome and placental characteristics of monochorionic diamniotic twin pairs with early- and late-onset discordant growthAmerican Journal of Obstetrics and Gynecology, 2008
- High frequency of iatrogenic monozygotic twins with administration of clomiphene citrate and a change in chorionicityFertility and Sterility, 2006
- Spontaneous embryonic loss rates in twin and singleton pregnancies after transfer of top- versus intermediate-quality embryosFertility and Sterility, 2005
- Assisted Reproductive Technology and Pregnancy OutcomeObstetrics & Gynecology, 2005