Prevalences and pregnancy outcome of vanishing twin pregnancies achieved by in vitro fertilization versus natural conception

Vanishing twin pregnancies have a lower prevalence and a worse perinatal outcome after in vitro fertilization/ intracytoplasmic sperm injection as compared with spontaneously conceived counterparts.

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Volume 106, Issue 6, Pages 1399-1406

Authors:

Virág Márton, M.D., János Zádori, M.D., Ph.D., Zoltan Kozinszky, M.D., Ph.D., Attila Keresztúri, M.D., Ph.D.

Abstract:

Objective

To evaluate whether vanishing twin (VT) pregnancies achieved by in vitro fertilization and intracytoplasmic sperm injection (IVF–ICSI) had a more adverse perinatal outcome than those after natural conception.

Design

Longitudinal, retrospective cohort study.

Setting

Tertiary university hospital.

Patient(s)

Three hundred and six (78 after IVF–ICSI and 228 after natural conception) VT pregnancies over a 22-year period, with VT cases matched to primarily singleton controls.

Intervention(s)

None.

Main Outcome Measure(s)

Obstetric and neonatal outcome data.

Result(s)

The incidence of VT was statistically significantly higher after natural conception (18.2% of twins) than after IVF–ICSI (12.6% of twins). The odds of VT in pregnancies complicated with pregestational or gestational diabetes were disproportionally higher in IVF–ICSI cases than in spontaneously conceived VT pregnancies (adjusted odds ratio [AOR]: 0.80 vs. 3.10 and 1.00 vs. 1.07, respectively). Previous induced abortion (AOR 1.34) or second-trimester fetal loss (AOR 3.3) increased the risk of VT pregnancies after spontaneous conception. Gestational diabetes mellitus in both the previous (AOR 5.41) and the present (AOR 2.3) pregnancy as well as chronic maternal diseases (AOR 3.5) and placentation anomalies all represented independent risk factors for VT after IVF–ICSI.

Conclusion(s)

Vanishing twin pregnancies had a lower prevalence and a worse perinatal outcome after IVF–ICSI as compared with those of their spontaneously conceived counterparts.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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