A comparison of IVF triplets; electively vs. spontaneously reduced to twin gestations

Abstract

OBJECTIVE: To assess the obstetric outcome of IVF triplets.DESIGN: Retrospective cohort study.MATERIALS AND METHODS: 76 out of 80 IVF triplet pregnancies conceived at McGill University between 1997 and 2009 who had complete follow up data were included. Outcomes of pregnancies continued as triplets (TR), electively reduced to twins (ER), and spontaneously reduced to twins (SR) were analyzed and compared to IVF twin pregnancies (TW) using ANOVA & Chi square tests.Tabled 1Gestational age at deliveryGROUPTripletsTriplets electively reduced to twinsTriplets spontaneously reduced to twinsTwinsLIVE BIRTH ≤31 weeks (%)22 (57.9)3 (13.0)3 (20.0)60 (12.3)LIVE BIRTH 32 – 36 weeks (%)16 (42.1)9 (39.1)6 (40.0)167 (34.1)LIVE BIRTH ≥37 weeks (%)0 (0)11 (47.8)6 (40.0)263 (53.7)Overall p = 0.01; when triplets are excluded p = 0.96, spontaneous vs elective reduction p =0.96. Open table in a new tab TR are more likely to deliver ≤31 wks than are the other groups and less likely to deliver at ≥37 wks (<0.01). ER and SR are likely to be delivered at similar GA (p=0.96) and did not differ from TW (p=0.96). Comparing largest child born of the set, birth weights were similar across all groups for preterm deliveries, however among term deliveries ER was lighter (2300g) than SR (3031g) or TW (2944g) (p<0.01).CONCLUSION: Elective fetal reduction to twins decreases deliveries ≤31 wks GA and encourages delivery ≥37 wks. ER and SR result in deliveries at similar gestational ages with equivalent rates of prematurity, but children from ER are more likely to have growth restriction. OBJECTIVE: To assess the obstetric outcome of IVF triplets. DESIGN: Retrospective cohort study. MATERIALS AND METHODS: 76 out of 80 IVF triplet pregnancies conceived at McGill University between 1997 and 2009 who had complete follow up data were included. Outcomes of pregnancies continued as triplets (TR), electively reduced to twins (ER), and spontaneously reduced to twins (SR) were analyzed and compared to IVF twin pregnancies (TW) using ANOVA & Chi square tests. Overall p = 0.01; when triplets are excluded p = 0.96, spontaneous vs elective reduction p =0.96. TR are more likely to deliver ≤31 wks than are the other groups and less likely to deliver at ≥37 wks (<0.01). ER and SR are likely to be delivered at similar GA (p=0.96) and did not differ from TW (p=0.96). Comparing largest child born of the set, birth weights were similar across all groups for preterm deliveries, however among term deliveries ER was lighter (2300g) than SR (3031g) or TW (2944g) (p<0.01). CONCLUSION: Elective fetal reduction to twins decreases deliveries ≤31 wks GA and encourages delivery ≥37 wks. ER and SR result in deliveries at similar gestational ages with equivalent rates of prematurity, but children from ER are more likely to have growth restriction.