Abstract
Purpose of Investigation: With the advent of fertility treatment the number of twin gestations has increased considerably. These pregnancies are associated with many maternal and perinatal complications, mainly due to prematurity. The aim of this study was to assess the effectiveness of a fully embedded prophylactic vaginal cervical cerclage in reducing the rate of prematurity in twin pregnancies following ART. Materials and Methods: A prophylactic vaginal cervical cerclage was applied in forty three twin pregnancies conceived following fertility treatments. The cerclage suture was fully embedded under the vaginal mucosa in order to minimize the risk of infection. Results: The mean gestational age at delivery was 35+4 weeks and the mean delivery weight was 2,238 grams. No differences between the type of fertility treatment used was noted in the outcome measures studied. Conclusion: Twin pregnancies conceived with the aid of fertility treatment, benefited from the application of a prophylactic vaginal cervical cerclage.
Highlights
Over the last 40 years, the rate of multiple pregnancies has increased considerably mainly due to the wider use of assisted reproductive technologies: ART, e.g. IVF, intrauterine insemination (IUI) and controlled ovarian stimulation (COS)
Based on the latest published data of the European Society of Human Reproduction and Embryology (ESHRE), in the year 2014, 17.0% of the combined IVF and intracystoplasmic sperm injection (ICSI) cycles and 7.7% of the cycles following IUI resulted in twin gestations [1]
The modification refers to the cerclage suture which was fully embedded under the vaginal mucosa
Summary
Over the last 40 years, the rate of multiple pregnancies has increased considerably mainly due to the wider use of assisted reproductive technologies: ART, e.g. IVF, intrauterine insemination (IUI) and controlled ovarian stimulation (COS). Based on the latest published data of the European Society of Human Reproduction and Embryology (ESHRE), in the year 2014, 17.0% of the combined IVF and intracystoplasmic sperm injection (ICSI) cycles and 7.7% of the cycles following IUI resulted in twin gestations [1]. Multiple gestations are always considered high-risk due to the increased incidence of maternal and neonatal complications [3]. It has been reported that following ART, the risk of extreme preterm birth (< 28 weeks) is increased [1]. The increase of maternal age of women opting for IVF is associated with elevated rates of obstetric complications. Apart from maternal factors, dizygotic twins conceived, following IVF, have a higher risk of preterm delivery when compared to non-IVF dizygotic twins [5]
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