ARE THE TWINS, BORN AFTER AN IVF-ET PROCEDURE ANY DIFFERENT THAN TWINS, BORN AFTER SPONTANEOUS CONCEPTION?
Abstract
Background. Multiple pregnancy is in itself already a risk factor for the course and outcome of the pregnancy and birth. Its frequency in in-vitro fertilisation is approximately twenty fold in comparison to natural conception which is also why it is one of the main problem areas of pregnancy and birth after an IVF-ET procedure. The aim of our research is to determine whether the twins, born after an IVF-ET procedure are any different than twins, born after spontaneous conception.
Methods. The research was retrospective in nature. It included 1511 twin pregnancy patients who gave birth to twins between April 1987 and May 1995 and between January 1997 and December 1999. Our research group consisted of 255 mothers and 510 twins, born after an IVF-ET procedure. The research was divided into a cohort and controlled study. In the cohort study the research group was compared to the entire Ljubljana cohort of 1256 mothers and 2512 twins resulting from spontaneous conception. In the controlled study 93 mothers and 186 twins from the research group were compared with 93 mothers and 186 newborns after spontaneous conception. In this group the mothers matched the research group in age, parity and birth year. The course of and complications during the pregnancy, and the course, complications and outcome of the birth as well as the characteristics of the newborns were compared.
Results. Certain serious complications during the course of the pregnancy, including hypertension, gestation diabetes and threatened preterm labours, were no more frequent with the IVF group of mothers with twin pregnancy than with the control group. However more bleeding in the first trimester and less proteinuria were determined in comparison to the control group. During the course of birth and its outcome more premature labours were determined (62.3–68.8% vs. 51.4– 50.5%), a 6 to 7 days lower average gestation age, a coresponding birth weight, three times more elective and urgent caesarean sections were determined for the IVF group than for the control group and the differences were all statistically significant.
Conclusions. Multiple pregnancies are a complication of an IVF-ET procedure. Women who conceive after an IVF-ET procedure and with a twin pregnancy outcome are not subject to any more danger than pregnant women after spontaneous conception. Children are born somewhat earlier and are therefore lighter, however the perinatal outcome of newborns is no different and the morbidity and mortality rates are similar to that of newborns after spontaneous conception.
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References
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