Monozygotic pregnancies conceived by in vitro fertilization: understanding their prognosis  

Oleh:

Vela, Gerardo ; Luna, Martha ; Barritt, Jason ; Sandler, Benjamin ; Copperman, Alan B.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Fertility and Sterility (keterangan: ada di ClinicalKey) vol. 95 no. 02 (Feb. 2011), page 606-610 .
Topik: FERTILITY; ART; high-order multiple pregnancy; IVF; monozygotic; multifetal pregnancy reduction; pregnancy outcome

Ketersediaan

Perpustakaan FK Nomor Panggil: F02.K.2011.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

Lihat Detail Induk

Isi artikel

Objective To analyze the outcomes and particular characteristics of monozygotic (MZ) pregnancies conceived by in vitro fertilization (IVF). Design Retrospective data analysis. Setting Large private-academic fertility center. Patient(s) IVF-conceived MZ pregnancies. Intervention(s) Statistical analysis of MZ pregnancy outcomes depending on fetal order and pregnancy reductions status. Main Outcome Measure(s) Spontaneous pregnancy reduction, pregnancy loss, take-home baby rate, perinatal mortality, gestational age at delivery, and birth weight. Result(s) A total of 72 of 3,426 pregnancies (2.1%) were MZ, and 70 were included in the study. Of these, 34 cases (48.5%) were high-order multiple pregnancies (HOMP), and 36 (51.5%) were non-HOMP. In the HOMP group, only 2.9% (1 of 34) had a complete pregnancy loss while 38.8% (14 of 36) of the non-HOMP were lost by 20 weeks' gestation. Of the HOMP patients, 73.1% therapeutically reduced the MZ component, and a statistically significant difference in gestational age of delivery (37.8 ± 3.2 vs. 28.1 ± 7.7) and birth weight (2796 ± 865.8 vs. 1110.0 ± 731.6) was seen when compared with nonreduced HOMP. Conclusion(s) Twinning with MZ is encountered in a small but important number of pregnancies derived from assisted reproduction. The prognosis for these patients is unfavorable, particularly for single-implantation MZ pregnancies and for nonreduced HOMP. Patients who do not spontaneously reduce a MZ-HOMP by 12 weeks may benefit from therapeutically reducing the MZ component of the pregnancy.

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