Minna E Geisler1, Anne O'Mahony2, Sarah Meaney3, John J Waterstone4, Keelin O'Donoghue2. 1. Cork Fertility Centre, Fernhurst Clinic, College Road, Cork, Ireland; Anu Research Centre, Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Wilton Road, Cork, Ireland. Electronic address: minnageisler@yahoo.com. 2. Anu Research Centre, Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Wilton Road, Cork, Ireland. 3. National Perinatal Epidemiology Centre, University College Cork, Ireland. 4. Cork Fertility Centre, Fernhurst Clinic, College Road, Cork, Ireland.
Abstract
OBJECTIVE: Twin pregnancy is associated with increased obstetric and perinatal risk. There are conflicting reports on whether assisted conception (ART) further increases these risks. The aim of this study is to assess the obstetric and perinatal outcomes of twin pregnancies according to mode of conception. STUDY DESIGN: A retrospective study of all viable dichorionic-diamniotic (DCDA) twin pregnancies (n=539) delivered at Cork University Maternity Hospital, Ireland between 2009 and 2012, divided according to spontaneous conception (SC) and ART conception, specifically IVF or ICSI. RESULTS: The ART conceived group were on average 4 years older (36.8±4.23 vs 32.3±4.93 years) and more frequently nulliparous (73.7%; n=126 vs 36.1%; n=133) than their SC counterparts (p<0.001). There was no significant difference in maternal antenatal complications. ART twins were twice as likely to be delivered by caesarean section (CS) (OR 2.35; 95% CI 1.76-3.14). There was no significant difference in the rates of preterm birth or NICU admission according to mode of conception. ART conceived twins were almost twice as likely to be delivered moderately preterm (32-33(+6)) (OR 1.98, 95% CI 1.21-3.23) and were more likely to have RDS and neonatal hypoglycaemia CONCLUSIONS: Twin pregnancy, irrespective of mode of conception, carries an increased risk of morbidity and mortality for both mother and babies and therefore couples should be counselled regarding the increased risk of iatrogenic twinning associated with double embryo transfer. However, for those that do conceive twins, they can be advised that assisted conception conveys no significant disadvantage over naturally conceived twin pregnancies.
OBJECTIVE: Twin pregnancy is associated with increased obstetric and perinatal risk. There are conflicting reports on whether assisted conception (ART) further increases these risks. The aim of this study is to assess the obstetric and perinatal outcomes of twin pregnancies according to mode of conception. STUDY DESIGN: A retrospective study of all viable dichorionic-diamniotic (DCDA) twin pregnancies (n=539) delivered at Cork University Maternity Hospital, Ireland between 2009 and 2012, divided according to spontaneous conception (SC) and ART conception, specifically IVF or ICSI. RESULTS: The ART conceived group were on average 4 years older (36.8±4.23 vs 32.3±4.93 years) and more frequently nulliparous (73.7%; n=126 vs 36.1%; n=133) than their SC counterparts (p<0.001). There was no significant difference in maternal antenatal complications. ART twins were twice as likely to be delivered by caesarean section (CS) (OR 2.35; 95% CI 1.76-3.14). There was no significant difference in the rates of preterm birth or NICU admission according to mode of conception. ART conceived twins were almost twice as likely to be delivered moderately preterm (32-33(+6)) (OR 1.98, 95% CI 1.21-3.23) and were more likely to have RDS and neonatal hypoglycaemia CONCLUSIONS: Twin pregnancy, irrespective of mode of conception, carries an increased risk of morbidity and mortality for both mother and babies and therefore couples should be counselled regarding the increased risk of iatrogenic twinning associated with double embryo transfer. However, for those that do conceive twins, they can be advised that assisted conception conveys no significant disadvantage over naturally conceived twin pregnancies.
Authors: Aaron K Styer; Barbara Luke; Wendy Vitek; Mindy S Christianson; Valerie L Baker; Alicia Y Christy; Alex J Polotsky Journal: Fertil Steril Date: 2016-03-18 Impact factor: 7.329
Authors: Su Jin Sung; Seung Mi Lee; Sunmin Kim; Byoung Jae Kim; Chan Wook Park; Joong Shin Park; Jong Kwan Jun Journal: J Korean Med Sci Date: 2018-03-26 Impact factor: 2.153