Mario Vega1, Sahar Zaghi2, Erkan Buyuk1, Sangita Jindal3. 1. Albert Einstein College of Medicine, Department of Obstetrics/Gynecology and Women's Health, Bronx, New York; Montefiore's Institute for Reproductive Medicine and Health, Hartsdale, New York. 2. Albert Einstein College of Medicine, Department of Obstetrics/Gynecology and Women's Health, Bronx, New York. 3. Albert Einstein College of Medicine, Department of Obstetrics/Gynecology and Women's Health, Bronx, New York; Montefiore's Institute for Reproductive Medicine and Health, Hartsdale, New York. Electronic address: sjindal@montefiore.org.
Abstract
OBJECTIVE: To study the incidence and risk factors of multiple pregnancies after elective single ET. DESIGN: Historic cohort. SETTING: Not applicable. PATIENT(S): Women <35 years of age undergoing elective single ET entered in the SART CORS database from 2010 to 2013. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE(S): Rate of sex discordant pregnancies. Rate of same sex pregnancies and risk factors for both same sex and sex discordant pregnancies. RESULT(S): A total of 32,600 cycles were reported to SART CORS during this time period. There were 15,143 pregnancies from which 14,888 were singletons (98.3%), 23 sex discordant (0.15%) multiple pregnancies, 226 (1.5%) sex concordant multiple pregnancies, and 6 (0.01%) pregnancies without sex information. When Weinberg's differential rule was applied, the rate of dizygotic pregnancies was calculated to be 18%. Unexplained infertility was found to be the biggest risk factor for sex discordant multiple pregnancies (adjusted odds ratio 4.33, 95% confidence interval 1.4-13.1), followed by elevated body mass index (BMI). The only risk factor found for sex concordant pregnancies was undergoing a fresh transfer (adjusted odds ratio 1.4, 95% confidence interval 1.02-1.95). CONCLUSION(S): Elective single ET improves, but does not completely eliminate the risk of multiple pregnancies. Patients should be counseled that there might be up to a ∼2% risk of multiple pregnancies, of which up to 18% can be dizygotic. Patients with elevated BMI and unexplained fertility may be at higher risk for sex discordant multiple pregnancies and patients undergoing fresh cycles may be at higher risk for sex concordant multiple pregnancies.
OBJECTIVE: To study the incidence and risk factors of multiple pregnancies after elective single ET. DESIGN: Historic cohort. SETTING: Not applicable. PATIENT(S): Women <35 years of age undergoing elective single ET entered in the SART CORS database from 2010 to 2013. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE(S): Rate of sex discordant pregnancies. Rate of same sex pregnancies and risk factors for both same sex and sex discordant pregnancies. RESULT(S): A total of 32,600 cycles were reported to SART CORS during this time period. There were 15,143 pregnancies from which 14,888 were singletons (98.3%), 23 sex discordant (0.15%) multiple pregnancies, 226 (1.5%) sex concordant multiple pregnancies, and 6 (0.01%) pregnancies without sex information. When Weinberg's differential rule was applied, the rate of dizygotic pregnancies was calculated to be 18%. Unexplained infertility was found to be the biggest risk factor for sex discordant multiple pregnancies (adjusted odds ratio 4.33, 95% confidence interval 1.4-13.1), followed by elevated body mass index (BMI). The only risk factor found for sex concordant pregnancies was undergoing a fresh transfer (adjusted odds ratio 1.4, 95% confidence interval 1.02-1.95). CONCLUSION(S): Elective single ET improves, but does not completely eliminate the risk of multiple pregnancies. Patients should be counseled that there might be up to a ∼2% risk of multiple pregnancies, of which up to 18% can be dizygotic. Patients with elevated BMI and unexplained fertility may be at higher risk for sex discordant multiple pregnancies and patients undergoing fresh cycles may be at higher risk for sex concordant multiple pregnancies.
Authors: Jessica E McLaughlin; Byeong Y Choi; Qianqian Liu; Jonathan A Gelfond; Randal D Robinson; T Arthur Chang; Jennifer F Knudtson Journal: J Assist Reprod Genet Date: 2019-11-12 Impact factor: 3.412
Authors: Jinpeng Rao; Feng Qiu; Shen Tian; Ya Yu; Ying Zhang; Zheng Gu; Yiting Cai; Fan Jin; Min Jin Journal: J Int Med Res Date: 2021-12 Impact factor: 1.671