Perinatal Outcomes In Monozygotic Pregnancies Resulting From Assisted Reproductive Technology Procedures: A Single-Center 6-Year Experience Based On A Large Cohort Of Pregnancies

Overview

Journal JBRA Assist Reprod

Specialty Reproductive Medicine

Date 2022 May 16

PMID 35575661

Authors

Nur Dokuzeylul Gungor

Tugba Gurbuz

Affiliations

Soon will be listed here.

Abstract

Objective: Monozygotic twin (MZT) pregnancies increase the risk of maternal and infant mortality and include many complications. The present study describes our assisted reproductive technology (ART) procedures from the viewpoint of perinatal outcomes in MZT pregnancies.

Methods: In this retrospective clinical cross-sectional study, 1159 in vitro fertilization (IVF) cycles performed between October 2014 and December 2019 were reviewed and perinatal outcomes and general clinical conditions analyzed.

Results: Sixteen MZT pregnancies were observed, resulting in an incidence of 1.38%. The MZT pregnancy incidence for patients aged ≤35 and >35 years were 0.2% and 1.1%, respectively. Eight MZT pregnancies resulted in live births, while five ended in miscarriage. A significant positive correlation was found between the number of attempts and the age of female (r:0.674; p=0.004) and male (r:0.657; p=0.006) partners. Cumulus-Oocytes Complexes (COC) (r:0.635; p=0.008), Metaphase II Oocyte (MIIO) (r:0.627; p=0.009), Pronucleus Oocyte (PO) (r:0.585; p=0.017) were correlated with serum AMH levels. The number of MZT was positively correlated with male partner age (r:0.527; p=0.036) and negatively correlated with embryo transfer day (ETd) (r:-0.548; p=0.028).

Conclusions: The incidence of MZT pregnancies observed in this study was similar to the incidence reported in the literature, although risk was more pronounced among women aged >35 years. Due to potential risks for mothers and fetuses, MZT pregnancies may become a problem as the number of individuals seeking IVF continues to increase.

References

Ballesta-Castillejos A, Gomez-Salgado J, Rodriguez-Almagro J, Ortiz-Esquinas I, Hernandez-Martinez A . Obstetric and perinatal complications associated with assisted reproductive treatment in Spain. J Assist Reprod Genet. 2019; 36(12):2435-2445. PMC: 6911128. DOI: 10.1007/s10815-019-01631-6. View

Dobrosavljevic A, Rakic S, Mihajlovic S . Risk of spontaneous preterm labor in pregnancies achieved by in vitro fertilization and complicated with severe form of ovarian hyperstimulation syndrome: A case control study. Pak J Med Sci. 2019; 35(4):923-928. PMC: 6659057. DOI: 10.12669/pjms.35.4.145. View

La Marca A, Nelson S, Sighinolfi G, Manno M, Baraldi E, Roli L . Anti-Müllerian hormone-based prediction model for a live birth in assisted reproduction. Reprod Biomed Online. 2011; 22(4):341-9. DOI: 10.1016/j.rbmo.2010.11.005. View

Loh J, Maheshwari A . Anti-Mullerian hormone--is it a crystal ball for predicting ovarian ageing?. Hum Reprod. 2011; 26(11):2925-32. DOI: 10.1093/humrep/der271. View

Lamazou F, Genro V, Fuchs F, Grynberg M, Gallot V, Achour-Frydman N . [Serum AMH level is not a predictive value for IVF in modified natural cycle: analysis of 342 cycles]. J Gynecol Obstet Biol Reprod (Paris). 2011; 40(3):205-10. DOI: 10.1016/j.jgyn.2011.02.002. View

Elias F, Weber-Adrian D, Pudwell J, Carter J, Walker M, Gaudet L . Neonatal outcomes in singleton pregnancies conceived by fresh or frozen embryo transfer compared to spontaneous conceptions: a systematic review and meta-analysis. Arch Gynecol Obstet. 2020; 302(1):31-45. PMC: 7266861. DOI: 10.1007/s00404-020-05593-4. View

Shevell T, Malone F, Vidaver J, Porter T, Luthy D, Comstock C . Assisted reproductive technology and pregnancy outcome. Obstet Gynecol. 2005; 106(5 Pt 1):1039-45. DOI: 10.1097/01.AOG.0000183593.24583.7c. View

Inal H, Kahyaoglu I, Turkkani A, Tuzluoglu D, Yilmaz N . Retrospective comparison of intracytoplasmic sperm injection outcomes of sperm retrieved from a testicular biopsy and freshly ejaculated semen in oligozoospermia. Rev Int Androl. 2018; 16(4):131-136. DOI: 10.1016/j.androl.2017.06.006. View

Zhu L, Zhang Y, Liu Y, Zhang R, Wu Y, Huang Y . Maternal and Live-birth Outcomes of Pregnancies following Assisted Reproductive Technology: A Retrospective Cohort Study. Sci Rep. 2016; 6:35141. PMC: 5071829. DOI: 10.1038/srep35141. View

10.

Gee R, Dickey R, Xiong X, Clark L, Pridjian G . Impact of monozygotic twinning on multiple births resulting from in vitro fertilization in the United States, 2006-2010. Am J Obstet Gynecol. 2013; 210(5):468.e1-6. DOI: 10.1016/j.ajog.2013.12.034. View

11.

Fanchin R, Lozano D, Frydman N, Gougeon A, Clemente N, Frydman R . Anti-Müllerian hormone concentrations in the follicular fluid of the preovulatory follicle are predictive of the implantation potential of the ensuing embryo obtained by in vitro fertilization. J Clin Endocrinol Metab. 2007; 92(5):1796-802. DOI: 10.1210/jc.2006-1053. View

12.

Gurbuz A, Gode F, Ozcimen N . Non-Invasive Isthmocele Treatment: A New Therapeutic Option During Assisted Reproductive Technology Cycles?. J Clin Med Res. 2020; 12(5):307-314. PMC: 7239582. DOI: 10.14740/jocmr4140. View

13.

Fernandes T, Carvalho P, Flosi F, Baiao A, Junior S . Perinatal Outcome of Discordant Anomalous Twins: A Single-Center Experience in a Developing Country. Twin Res Hum Genet. 2016; 19(4):389-92. DOI: 10.1017/thg.2016.42. View

14.

Ebner T, Sommergruber M, Moser M, Shebl O, Schreier-Lechner E, Tews G . Basal level of anti-Müllerian hormone is associated with oocyte quality in stimulated cycles. Hum Reprod. 2006; 21(8):2022-6. DOI: 10.1093/humrep/del127. View

15.

Chuang C, Chen C, Chao K, Chen S, Ho H, Yang Y . Age is a better predictor of pregnancy potential than basal follicle-stimulating hormone levels in women undergoing in vitro fertilization. Fertil Steril. 2003; 79(1):63-8. DOI: 10.1016/s0015-0282(02)04562-4. View

16.

Osianlis T, Rombauts L, Gabbe M, Motteram C, Vollenhoven V . Incidence and zygosity of twin births following transfers using a single fresh or frozen embryo. Hum Reprod. 2014; 29(7):1438-43. DOI: 10.1093/humrep/deu064. View

17.

Tummers P, de Sutter P, Dhont M . Risk of spontaneous abortion in singleton and twin pregnancies after IVF/ICSI. Hum Reprod. 2003; 18(8):1720-3. DOI: 10.1093/humrep/deg308. View

18.

Vega M, Zaghi S, Buyuk E, Jindal S . Not all twins are monozygotic after elective single embryo transfer: analysis of 32,600 elective single embryo transfer cycles as reported to the Society for Assisted Reproductive Technology. Fertil Steril. 2018; 109(1):118-122. DOI: 10.1016/j.fertnstert.2017.10.003. View

19.

Aboulghar M, El-Faissal Y, Kamel A, Mansour R, Serour G, Aboulghar M . The effect of early administration of rectal progesterone in IVF/ICSI twin pregnancies on the preterm birth rate: a randomized trial. BMC Pregnancy Childbirth. 2020; 20(1):351. PMC: 7285559. DOI: 10.1186/s12884-020-03033-4. View

20.

Kevenaar M, Themmen A, Laven J, Sonntag B, Lie Fong S, Uitterlinden A . Anti-Müllerian hormone and anti-Müllerian hormone type II receptor polymorphisms are associated with follicular phase estradiol levels in normo-ovulatory women. Hum Reprod. 2007; 22(6):1547-54. DOI: 10.1093/humrep/dem036. View