Outcome of monochorionic-biamniotic twins conceived by assisted reproduction: a population-based study

Andreja Trojner Bregar; Isaac Blickstein; Ivan Verdenik; Miha Lucovnik; Natasa Tul

doi:10.1515/jpm-2015-0406

Article

Outcome of monochorionic-biamniotic twins conceived by assisted reproduction: a population-based study

Andreja Trojner Bregar , Isaac Blickstein , Ivan Verdenik , Miha Lucovnik and Natasa Tul

Published/Copyright: May 24, 2016

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From the journal Journal of Perinatal Medicine Volume 44 Issue 8

Abstract

Objecive:

To evaluate the perinatal outcome of monochorionic-diamniotic twins conceived by assisted reproduction technology (ART).

Methods:

We compared data from a national population-based perinatal registry on perinatal outcomes of monochorionic-diamniotic twins conceived by ART with their dichorionic counterparts and with spontaneous monochorionic-diamniotic twins. We compared maternal characteristics, pregnancy complications and perinatal outcomes.

Results:

Monochorionic-diamniotic twin pregnancies (n=45) comprised 5.5% of all ART twins, and 9.3% of all monochorionic twins in this dataset. ART does not appear to increase the already high risk of monochorionicity compared to spontaneous conception, with the latter having an increased incidence for birth weight <1500 g [odds ratio (OD) 2.6, 95% confidence interval (CI) 1.2–5.4].

Conclusion:

Our results disagree with hospital-based data and suggest that monochorionic-diamniotic twins following ART are not at increased risk of adverse perinatal outcomes compared to spontaneous monochorionic-diamniotic twins as well as to dichorionc twins conceived by ART.

Keywords: Assisted reproduction; monochorionic-diamniotic twins; pregnancy complications

Corresponding author: Isaac Blickstein, MD, Department of Obstetrics and Gynecology, Kaplan Medical Center, 76100 Rehovot, Israel, Tel.: +972-545-201789, Fax: +972-89411944

References

[1] Derom C, Leroy F, Vlietinck R, Fryns JP, Derom R. High frequency of iatrogenic monozygotic twins with administration of clomiphene citrate and a change in chorionicity. Fertil Steril. 2006;85:755–7.10.1016/j.fertnstert.2005.08.034Search in Google Scholar

[2] Blickstein I, Jones C, Keith LG. Zygotic-splitting rates after single-embryo transfers in in vitro fertilization. N Engl J Med. 2003;348:2366–7.10.1056/NEJMc026724Search in Google Scholar

[3] Blickstein I, Keith LG. On the possible cause of monozygotic twinning: lessons from the 9-banded armadillo and from assisted reproduction. Twin Res Hum Genet. 2007;10:394–9.10.1375/twin.10.2.394Search in Google Scholar

[4] Blickstein I. Estimation of iatrogenic monozygotic twinning rate following assisted reproduction: pitfalls and caveats. Am J Obstet Gynecol. 2005;192:365–8.10.1016/j.ajog.2004.11.012Search in Google Scholar

[5] Mascarenhas M, Kamath MS, Muthukumar K, Mangalaraj AM, Chandy A, Aleyamma T. Obstetric outcomes of monochorionic pregnancies conceived following assisted reproductive technology: a retrospective study. J Hum Reprod Sci. 2014;7:119–24.10.4103/0974-1208.138870Search in Google Scholar

[6] Ghalili A, McLennan A, Pedersen L, Kesby G, Hyett J. Outcomes of monochorionic diamniotic twin pregnancies: a comparison of assisted and spontaneous conceptions. Aust N Z J Obstet Gynaecol. 2013;53:437–42.10.1111/ajo.12105Search in Google Scholar

[7] Simoes T, Queiros A, Marujo AT, Valdoleiros S, Silva P, Blickstein I. Outcome of Monochorionic Twins Conceived by Assisted Reproduction. Fertil Steril. 2015;104:629–32.10.1016/j.fertnstert.2015.06.002Search in Google Scholar

[8] Sperling L, Kiil C, Larsen LU, Qvist I, Schwartz M, Jørgensen C, et al. Naturally conceived twins with monochorionic placentation have the highest risk of fetal loss. Ultrasound Obstet Gynecol. 2006;28:644–52.10.1002/uog.3820Search in Google Scholar

[9] Fitzsimmons BP, Bebbington MW, Fluker MR. Perinatal and neonatal outcomes in multiple gestations: assisted reproduction versus spontaneous conception. Am J Obstet Gynecol. 1998;179:1162–7.10.1016/S0002-9378(98)70125-5Search in Google Scholar

[10] Minakami H, Sayama M, Honma Y, Matsubara S, Koike T, Sato I, et al. Lower risks of adverse outcome in twins conceived by artificial reproductive techniques compared with spontaneously conceived twins. Hum Reprod. 1998;13:2005–8.10.1093/humrep/13.7.2005Search in Google Scholar PubMed

[11] Lynch A, McDuffie R, Stephens J, Murphy J, Faber K, Orleans M. The contribution of assisted conception, chorionicity and other risk factors to very low birthweight in a twin cohort. Br J Obstet Gynaecol. 2003;110:405–10.10.1046/j.1471-0528.2003.02342.xSearch in Google Scholar

[12] Narine LH, Vezmar M, Sutija VG, Shah B, Sidhu S, Schwarz RH, et al. Mode of conception, placental morphology and perinatal outcome of twin gestations. J Perinat Med. 2003;31:99–104.10.1515/JPM.2003.013Search in Google Scholar PubMed

The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2015-11-27

Accepted: 2016-4-11

Published Online: 2016-5-24

Published in Print: 2016-11-1

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Articles in the same Issue

https://doi.org/10.1515/jpm-2015-0406

Keywords for this article

Assisted reproduction; monochorionic-diamniotic twins; pregnancy complications