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.

  • Isaac Blickstein

    Thank you for your comment. Yes, we did consider controlling for maternal age (and parity). It is true the older maternal age (and parity) are associated with obstetrical outcome (in opposing directions). However, our sample size did not allow to reach a conclusion. Further studies are certainly required.

  • Jason M. Franasiak

    A very interesting manuscript. It is often challenging to compare outcomes in the ART population versus normal controls. In this study the ART population was significantly older which is a risk factor for poor obstetrical outcomes. Did you consider controlling for maternal age in the analysis?

Translate »