Lower embryonic loss rates among twin gestations following assisted reproduction

Sala, Giovanni Battista La; Nucera, Giuseppe; Gallinelli, Andrea; Nicoli, Alessia; Villani, Maria Teresa; Blickstein, Isaac

doi:10.1007/s10815-005-4919-1

Cited by 19 publications

(8 citation statements)

References 13 publications

(27 reference statements)

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“…Assisted-reproduction twin pregnancies have reduced spontaneous EPL rates compared with assisted-reproduction singleton pregnancies and in particular after IVF/ICSI treatment (La Sala et al, 2005;Miró et al, 2012;Tummers et al, 2003). A recent study has shown that the overall rate of miscarriage is higher for women aged 34 years and that the difference in live-birth rate between twin and singleton pregnancies is 2.4-fold higher in older than in younger women (Miró et al, 2012).…”

Section: Early Pregnancy Loss In Assisted-reproduction Twinsmentioning

confidence: 99%

Do assisted-reproduction twin pregnancies require additional antenatal care?

Jauniaux

Ben‐Ami

Maymon

2013

Reproductive BioMedicine Online

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Iatrogenic twinning has become the main side-effect assisted reproduction treatment. We have evaluated the evidence for additional care that assisted-reproduction twins may require compared with spontaneous twins. Misacarriages are increased in women with tubal problems and after specific treatments. Assisted-reproduction twin pregnancies complicated by a vanishing twin after 8 weeks have an increased risk of preterm delivery and of low and very low birthweight compared with singleton assisted-reproduction pregnancies. Monozygotic twin pregnancies occur at a higher rate after assisted reproduction treatment and are associated with a higher risk of perinatal complications. The incidence of placenta praevia and vasa praevia is increased in assisted-reproduction twin pregnancies. Large cohort studies do not indicate a higher rate of fetal congenital malformations in assisted-reproduction twins. Overall, assisted-reproduction twins in healthy women <45 years of age are not associated with a notable increase in antenatal complication rates and thus do not require additional antenatal care compared with spontaneous twins. The risks of maternal and fetal morbidity and mortality associated with assisted-reproduction twins is only increased in women with a pre-existing medical condition such as hypertensive disorders and diabetes and most of these risks can be avoided with single-embryo transfer. Following the birth of the first IVF baby, rumours started to spread in both the medical literature and the media about the long-term health effects for children born following assisted reproduction treatment. However, after more than 30 years, the most common complications associated with IVF treatment remain indirect and technical such as the failure of treatment and ovarian hyperstimulation. Iatrogenic twinning has become the main side-effect of assisted reproduction treatment and the increasing number of twin pregnancies, in particular in older women, has generated numerous debates on the need for additional healthcare provision. In this review, we have evaluated the evidence for additional care that assisted-conception twin pregnancies may require compared with spontaneous twin pregnancies. Twin pregnancies are obviously at higher risk of perinatal complications than singletons due to a natural increase in the incidence of fetal anomalies, antenatal disorders and obstetric and neonatal complications associated with the development of two fetuses instead of one. Overall, our review indicates that some antenatal complications are more frequent in assisted-conception twin pregnancies than in spontaneous twin pregnancies but their prevalence is low and thus their impact on the morbidity and mortality of an individual assisted-conception twin pregnancy is limited. Assisted reproduction treatment has become available to older women with pre-existing maternal medical conditions such as chronic hypertension and diabetes. The increased obstetrical risks in this population must be considered prior to attempts at assisted conception, a...

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Section: Early Pregnancy Loss In Assisted-reproduction Twinsmentioning

confidence: 99%

Do assisted-reproduction twin pregnancies require additional antenatal care?

Jauniaux

Ben‐Ami

Maymon

2013

Reproductive BioMedicine Online

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“…La Sala et al [12] have reported that spontaneous miscarriage rates are higher in singleton IVF/intracytoplasmic sperm injection (ICSI) pregnancies (OR 5.0; 95% CI 2.2-11.9) compared with twin IVF (OR 3.0; 95% CI 1.9-9.9). They concluded that higher implantation rates could be a reflection of better uterine function.…”

Section: Miscarriagesmentioning

confidence: 99%

Reproductive outcomes after in-vitro fertilization

Mukhopadhaya

Arulkumaran

2007

Current Opinion in Obstetrics &Amp; Gynecology

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Some prospective observational studies compare maternal and perinatal outcomes in in-vitro fertilization pregnancies. Larger studies show that adverse pregnancy outcomes such as preeclampsia, gestational hypertension, placental abruption, placenta praevia, and preterm delivery increase significantly with in-vitro fertilization. Perinatal adverse outcomes such as prematurity and those related to plurality of the pregnancy also increase. All patients undergoing in-vitro fertilization should have careful counselling regarding these increased risks prior to treatment.

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“…The study by Lambers et al (15) demonstrated that the total pregnancy loss was 18.5% and 2.5% (P<.001) in singleton and twin gestations, respectively, which is comparable with our results. A study by La Sala et al (17) demonstrated that twins have a significantly lower miscarriage rate compared with singletons after IVF/ ICSI, which the investigators explained by stating that the higher implantation rate represented a better capacity of the uterus for early embryonic development. It is interesting to note that the ''single pregnancy from the start'' group, which was obviously the group with the lowest implantation rate, was the only group who demonstrated a significantly lower number of mature oocytes and 2PN oocytes and had the highest miscarriage rate.…”

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confidence: 99%