Neonatal and maternal outcomes comparing women undergoing two in vitro fertilization IVF singleton pregnancies and women undergoing one IVF twin pregnancy

Capsule:
Neonatal and maternal outcomes were dramatically better for women undergoing two IVF singleton pregnancies compared with one IVF twin pregnancy.

Authors:
Antonina Sazonova, M.D., Karin Källen, Ph.D., Ann Thurin-Kjellberg, M.D., Ph.D., Ulla-Britt Wennerholm, M.D., Ph.D., Christina Bergh, M.D., Ph.D.

Volume 99, Issue 3, Pages 731-737, 1 March 2013

Abstract:

Objective:
To compare outcomes for women undergoing two IVF pregnancies with singletons with women undergoing one IVF twin pregnancy. The concept of single embryo transfer in in vitro fertilization (IVF) has reduced the risks for both maternal and neonatal complications, but there is still a discussion whether or not twins are a desired outcome of IVF.

Design:
Register study.

Setting:
Births recorded in the Swedish Medical Birth Register and in the National Patient Register from 2002 to 2006.

Patient(s):
All reported twins after IVF with double embryo transfer (DET) (n=1982) and their mothers (n=991) and all mothers (n=921) who gave birth to two IVF singletons (n=1842).

Intervention:
None.

Main Outcome Measures:
Maternal and neonatal outcomes including severe neonatal morbidity.

Result(s):
Preterm birth (PTB), very preterm birth, low birth weight (LBW), very LBW, small for gestational age (SGA) were dramatically increased for IVF twins as compared with two IVF singletons with the same mother with adjusted odds ratio (AOR) between 4 and 16. Significantly higher rates of respiratory complications, sepsis and jaundice were detected among the IVF twins. Significantly higher rates of pre-eclampsia, preterm premature rupture of the membranes and cesarean section were observed for IVF twin pregnancies.

Conclusion(s):
The neonatal and maternal outcomes were dramatically better for women undergoing two IVF singleton pregnancies as compared with one IVF twin pregnancy after DET. These results support single embryo transfer to minimize the risks associated with twin pregnancies.

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