Risk factors for twin pregnancy in women undergoing double cleavage embryo transfer

Abstract

Background Two or more embryo transfers have been used to increase the success rate of live birth in traditional in vitro fertilization (IVF) strategy at the expense of increased risks of multiple pregnancy and adverse perinatal outcomes. The decision regarding the elective single embryo transfer or double embryo transfer remains inconclusive. The aim of this study was to investigate the risk factors for twin pregnancy in IVF. Methods Participants who underwent their first fresh IVF cycle where two cleavage stage embryos were transferred in Women’s Hospital of Zhejiang University between January 2010 and December 2018 were included in this retrospective cohort study. The primary outcome was twin delivery. Secondary outcomes included preterm birth and low birth weight Results Fifteen thousand four hundred fifty-nine women were available for final analysis, in which 1511 women resulted in twin delivery and 4788 women had singleton delivery. Female age over 35 was associated with reduced rates of twin pregnancy compared with female age at or less than 35 (9.5% vs 25.1%, aRR = 0.38 (0.27. 0.55)). Poor-type endometrium was associated with reduced rates of twin pregnancy (19.2% vs 27.5%, aRR = 0.75 (0.58. 0.96)). Two good-quality embryos for transfer was associated with significantly higher rates of twin pregnancy compared with one good-quality or none good-quality embryo (26% vs 12.8% vs 9.3%, aRR = 0.56 (0.45. 0.70), aRR = 0.44(0.26. 0.74)). Female age over 35 and none or one good-quality embryo for transfer were associated with reduced rate of low birth weight and preterm birth. Conclusion Women with age over 35, poor-type endometrium, one good-quality embryo or none good-quality embryo were associated with reduced rate for twin pregnancy.

Statistical Insights Into Machine Learning-Based Box Models for Pregnancy Care and Maternal Mortality Reduction: A Literature Survey

“…Multiple Pregnancies -Chep P et al [39], and Li-Chun Liu et al [33] stated that Carrying numerous fetuses, such as twins or triplets, might increase the chance of maternal problems.…”

A Balancing Act: Navigating Hypertensive Disorders of Pregnancy at Very Advanced Maternal Age, from Preconception to Postpartum

“…To improve IVF outcomes, patients of advanced maternal age often undergo the transfer of more than one embryo. This practice has resulted in a higher prevalence of multiple pregnancies in these patients, particularly when donor eggs, which have a higher implantation potential, are used [45]. Indeed, in 2018, the twin birth rate in the United States for patients over the age of 40 was 51/1000, compared with 17/1000 in patients under the age of 20 [46].…”