Abstract
BackgroundAssisted reproduction (ART) contributes to world-wide increases of twin pregnancies, in turn raising prematurity risks. Whether characteristics of ART cycles, resulting in twin gestations, can predict prematurity risks was the subject of this study.MethodsOne-hundred-and-six women, ages 20 to 39 years, with consecutive dichorionic-diamniotic (DC/DA) twin gestations were retrospectively investigated. All pregnancies investigated followed fresh ART cycles, with use of autologous gamets, and were delivered at a university-based high-risk, maternal-fetal medicine unit. Only premature deliveries (i.e., <37.0 weeks gestational age), with viable neonate(s) of ≥ 500 grams, were considered for analysis.ResultsAfter 1.8 +/- 1.2 ART cycles, 11.0 +/- 5.4 oocytes were retrieved and 2.4 +/- 0.9 embryos transferred in 106 women aged 31.6 +/- 4.2 years. Indications for ART treatment were male factor in 51.9%, female infertility in 27.4% and combined infertility in 20.8%. Though maternal age significantly influenced prematurity risk (p < 0.05), paternal age, maternal body mass index, indications for fertility treatment, number of previous ART attempts, oocytes retrieved or embryos transferred, as well as stimulation protocols and previous ART pregnancies, were not associated with gestational duration in twin pregnancies.SummaryExcept for female age, baseline and ART cycle characteristics do not allow for prediction of prematurity risk in dichorionic twin gestations after assisted reproduction.
Highlights
Assisted reproduction (ART) contributes to world-wide increases of twin pregnancies, in turn raising prematurity risks
A comparison of in vitro fertilization (IVF) cycle characteristics between study patients and DC twin gestations that delivered at term (i.e., ≥ 37 weeks; not eligible for enrollment) revealed no significant differences between the groups
A comparison of ART cycle characteristics between study patients and DC twin gestations that delivered at term (i.e., ≥ 37 weeks; not eligible for enrollment) revealed no significant differences between the groups
Summary
Assisted reproduction (ART) contributes to world-wide increases of twin pregnancies, in turn raising prematurity risks. Whether characteristics of ART cycles, resulting in twin gestations, can predict prematurity risks was the subject of this study. Assisted reproduction (ART), has come under criticism due to the increased risk of multiple births associated with this fertility treatments [2]. In contrast, currently results in twin rates of 21.7% with wide variations across the countries [3]. Twins (and higher order multiples), in comparison to singleton gestations, are at increased risk for prematurity-associated adverse perinatal outcome [4,5]. A broader application of single embryo transfer (SET) has been suggested to reduce this rising incidence of multiple pregnancies in the course of assisted reproduction without compromising pregnancy chances [6,7]
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