Outcome of monochorionic twins conceived by assisted reproduction

Capsule:
Monochorionic twins after assisted reproductive technology (ART) are at increased risk of adverse perinatal outcomes compared with spontaneous monochorionic twins and with dichorionc twins conceived by ART.

Authors:
Teresinha Simões, M.D., M.Sc., Alexandra Queirós, M.D., Ana Teresa Marujo, M.D., Sandra Valdoleiros, M.D., Patricia Silva, M.D., Isaac Blickstein, M.D.

Volume 104, Issue 3, Pages 629-632

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 = 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. Conclusion(s):
Monochorionic twins after ART are at increased risk of adverse perinatal outcomes compared with spontaneous monochorionic twins and with dichorionic twins conceived by ART.

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