Abstract
Unicornuate uteri are associated with infertility, miscarriage, preterm delivery and even uterine rupture. The aim of this research was to investigate the effects of unicornuate uterine anomaly on twin pregnancies after in vitro fertilization-embryo transfer (IVF-ET). A total of 206 women with unicornuate uteri (A singleton, B selective reduction (SR) of twins to a singleton, C twins) and 314 women with normal uteri (D SR of twins to a singleton, E twins) who delivered at ≥22 weeks were included. C was associated with a significantly lower live birth rate (adjusted odds ratio (aOR) 0.08, 95% confidence interval (CI), 0.01–0.69) and higher risks of preterm delivery (aOR 11.63, 95% CI, 4.85–27.92), perinatal mortality (aOR 11.43, 95% CI, 1.44–90.57) and low birth weight (aOR 5.92, 95% CI 1.94–18.06) than A, a 15-fold greater risk of preterm delivery (aOR 15.54, 95% CI 3.09–78.28) than B and a greater risk of preterm delivery (aOR 2.76, 95% CI 1.33–5.73) than E. After SR to a singleton, the perinatal outcomes were statistically similar between B and D. These results showed that the risk of twin pregnancies should be minimized in patients with unicornuate uterine anomaly undergoing IVF-ET.
Highlights
Congenital uterine anomalies are estimated to occur in 8–13% of infertile women[1,2]
We found that patients with unicornuate uteri who are carrying twins are at increased risk of adverse perinatal outcomes after in vitro fertilization-embryo transfer (IVF-ET)
selective reduction (SR) of twins to a singleton yielded much more satisfactory perinatal outcomes. These findings suggest that effort should be made to minimize the risk of twin pregnancies in patients with unicornuate uterine anomaly undergoing IVF-ET
Summary
Congenital uterine anomalies are estimated to occur in 8–13% of infertile women[1,2]. Unicornuate uteri, which result from the partial or complete failure of one paramesonephric duct to develop, account for 5–13%3 of all congenital uterine anomalies. Little is known about the effects of unicornuate uterine anomaly on twin pregnancies and the outcomes of SR to a singleton after IVF-ET. In this study, we compared the perinatal outcomes of twin pregnancies and SR to a singleton between women with and without a unicornuate uterus. The perinatal outcomes of singleton pregnancies, SR to a singleton and twin pregnancies were compared among women with a unicornuate uterus to investigate the effects of unicornuate uterine anomaly on twin pregnancies after IVF-ET
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