895 Maternal and neonatal outcomes associated with preimplantation genetic testing in IVF twin pregnancies

Abstract

The impact of preimplantation genetic testing (PGT) on pregnancy outcomes with twin gestations is not well known. The objective of this study was to determine whether PGT is associated with adverse maternal and neonatal outcomes in twin pregnancies conceived using vitro fertilization (IVF). Retrospective cohort of multiple gestations conceived via IVF and delivered within a university health system between January 2014 and August 2019. Higher-order multiple gestations (triplet or higher) and cases with missing outcome data were excluded. Adverse maternal outcomes, i.e. hypertensive disorders of pregnancy, abnormal placentation, preterm birth, and adverse neonatal outcomes were compared between twin pregnancies conceived after transfer of one or two PGT screened euploid embryos versus untested embryos. Statistical analysis included use of Chi-square and Wilcoxon rank sum tests, as well as multivariate backwards-stepwise logistic regression, with significance defined as P value < 0.05. Data was presented as adjusted Odds Ratios (OR) with 95% confidence intervals (95% CI). Of 145 twin pregnancies, 43 (29.7%) were conceived following euploid embryo transfer and 102 (70.3%) were conceived following untested embryo transfer. Women who underwent PGT had a significantly lower mean body mass index compared to those that did not (Table 1). Use of donor egg and IVF cycle type (fresh vs. frozen) also differed between the two groups (Table 1). After adjusting for potential confounders, there was no significant difference between the two groups with respect to adverse maternal outcomes or in adverse neonatal outcomes (Table 2). Our data suggest no increase in adverse maternal or neonatal outcomes associated with PGT in twin IVF pregnancies. While our findings are reassuring, future studies utilizing larger cohorts of twin pregnancies are needed.View Large Image Figure ViewerDownload Hi-res image Download (PPT)