A comparison of the outcomes between twin and reduced twin pregnancies produced through assisted reproduction

Cheang, Chong-U.; Huang, Lii-Shung; Lee, Tsung-Hsien; Liu, Chung‐Hsien; Shih, Yung‐Feng; Lee, Maw‐Sheng

doi:10.1016/j.fertnstert.2006.11.084

Cited by 33 publications

(29 citation statements)

References 18 publications

(39 reference statements)

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“…This is of particular interest in view of the finding that MFPR may be associated with an increased risk of extremely preterm birth ( ! 28 weeks) as compared with non-reduced twin pregnancies (4.8 vs. 1.8%, p = 0.004) [6] .…”

Section: Introductionmentioning

confidence: 91%

Outcomes of Multiplets

2008

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Outcomes, both short and long term, differ between singletons and multiplets. Recently, a number of large, well-designed studies have clarified these differences, particularly in light of major changes in perinatal and neonatal care that have influenced changing outcomes. Accordingly, this article will review risks for singletons, twins and higher-order multiples as whole groups and also after correction for gestational age and other potential confounding variables that differ markedly between the groups. In addition, we will focus on the effects of certain factors such as antenatal steroid therapy and gender. Finally, we will detail the specific long-term risks for multiples in terms of growth and neurodevelopmental disabilities.

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Section: Introductionmentioning

confidence: 91%

Outcomes of Multiplets

2008

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“…8 One way of reducing complications from multiple pregnancies associated with IVF has been to employ multifetal pregnancy reduction, with selective termination performed to reduce pregnancies to singletons or twins. However, complication rates in reduced pregnancies remain higher than non-reduced pregnancies (of the same number) [22]. There are potential neurological complications in the remaining fetus/fetuses [23].…”

Section: Risk For Women?mentioning

confidence: 98%

“…Reanalysis of the costs per child born (and including all of the excess health costs) favours DET, costing approximately US$3790 less per live born child compared with SET. 22 However, figures based on economic modeling of projected lifetime tax earnings (subtracting lifetime direct government costs, such as for education, health, pensions) are even more striking. Such modelling suggests that there is a net economic benefit of £110,000, or US$155,000, for each child conceived by IVF [59,60].…”

Section: Costs To Society?mentioning

confidence: 99%

“…Finally, although the problems of global overpopulation might legitimately affect reproductive policy, we contend that it would be unfair to impose restrictions on reproduction for those who require medical assistance to reproduce when there are no restrictions on those who reproduce naturally. 23 22 Using figures from Scotland et al [27], in young women, cost per live-born child with DET is £22,341.70, compared with £24,647.60 (calculated from Scotland et al Table 1-60 children per 100 cycles DET, 45 children per 100 cycles repeated SET1). 23 There are differences between natural reproduction and artificial reproduction that make it easier for governments to limit artificial reproduction than the natural form.…”

Section: Costs To Society?mentioning

confidence: 99%

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Double trouble: Should double embryo transfer be banned?

et al. 2015

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What role should legislation or policy play in avoiding the complications of in-vitro fertilization? In this article, we focus on single versus double embryo transfer, and assess three arguments in favour of mandatory single embryo transfer: risks to the mother, risks to resultant children, and costs to society. We highlight significant ethical concerns about each of these. Reproductive autonomy and non-paternalism are strong enough to outweigh the health concerns for the woman. Complications due to non-identity cast doubt on the extent to which children are harmed. Twinning may offer an overall benefit rather than burden to society. Finally, including the future health costs for children (not yet born) in reproductive policy is inconsistent with other decisions. We conclude that mandatory single embryo transfer is not justified and that a number of countries should reconsider their current embryo transfer policy.

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“…When the mechanism is uncertain, DNA analysis may be helpful. Fetal reduction has been suggested in high-order multiple pregnancies to decrease the rate of complications, but this procedure has its own complications and does not eliminate all the detrimental effects of these high-risk pregnancies (6).…”

mentioning

confidence: 99%