The course and outcomes of multiple pregnancy following assisted reproductive technology


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Objective. To study the course and outcomes of twin pregnancy following assisted reproductive technology (ART). Materials and methods. A total of 669 pregnant women with dichorionic diamniotic twins were examined. The patients were divided into two groups: group I included 266 (39.8%) patients who became pregnant after ART and group II consisted of 403 (60.2%) patients who became pregnant spontaneously. All pregnant women had a comprehensive examination, including fetometry, determining the length of the cervix, Doppler assessment, and treatment of all complications. The course and outcomes of pregnancy were evaluated in patients of both groups. Results. Group I (ART) compared to group II (spontaneous twin pregnancy) demonstrated a higher incidence of pregnancy complications, namely anemia in the 1st trimester (29.3 and 19.1%, respectively, р<0.001), miscarriage (3.4 and 0.5%;р<0.001), cervical incompetence (17.1 and 5.2%;р<0.001), preterm birth (59.5and 40.9%; р<0.05), fetal growth restriction (46.2 and 38.4%; р=0.04), oligohydramnios (6.6 and 2.7%; р<0.001), gestational diabetes mellitus (13.6 and 8.5%; р=0.01). Perinatal death also was 2.8 times higher in group I than in group II: 6.6% vs. 2.4% (р=0.01). Prematurity was found to determine most of the adverse perinatal outcomes in twin pregnancies in the ART group. Conclusion. Multiple pregnancy following ART in comparison with spontaneously conceived pregnancy is in the highest risk group due to the incidence of multiple gestational complications, therefore, the number of transferred embryos should be limited to one.

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Sobre autores

Sergey Kalashnikov

N.I. Pirogov Russian Natio

Email: homeksa@mail.ru
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Lali Sichinava

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: lalisichinava@gmail.com
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

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