Obstetric outcome of twin pregnancies conceived by in vitro fertilization and ovulation induction compared with those conceived spontaneously

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• 作者：Yael Adler-Levy ; Eitan Lunenfeld ; Amalia Levy
• 关键词：In vitro fertilization ; Ovulation induction ; Obstetric complications ; Neonatal complications ; Gestational diabetes mellitus ; Twins
• 刊名：European Journal of Obstetrics and Gynecology and Reproductive Biology
• 出版年：2007
• 期刊代码：92_03012115
• 类别：med
• 出版时间：August 2007
• 卷：133
• 期：2
• 页码：173-178
• 文件大小：129 K

摘要

To compare the obstetric characteristics of twin pregnancies conceived by in vitro fertilization (IVF) and ovulation induction with those conceived spontaneously.

Design

Case control study.

Setting: Tertiary Medical Center.

Patients: All twin deliveries that were achieved by IVF (n = 558) and ovulation induction (n = 478) from January 1988 through December 2002 were evaluated. Each group was compared with a control group that conceived spontaneously (n = 3694) and was delivered during the same period.

Interventions: Ovulation induction, IVF-ET.

Main outcome measures: Obstetrical complications.

Results

Multivariate analysis showed that patients who conceived with the assistance of IVF and ovulation induction had a significantly higher risk for gestational diabetes mellitus (odds ratio [OR] = 2.41, 95%confidence interval [CI] = 1.77–3.29 and OR = 1.71, CI = 1.2–2.42, respectively), cesarean section (OR = 2.17, 95%CI = 1.74–2.70 and OR = 1.76, CI = 1.43–2.16, respectively), and a lower gestational age at birth in the IVF group (OR = 0.91, 95%CI = 0.88–0.94), compared with their controls.

Conclusions

After controlling for maternal age, and nulliparity we demonstrated that twin pregnancies conceived with the assistance of IVF and ovulation induction are at increased risk for gestational diabetes mellitus, and delivery by cesarean section. In addition, IVF conceived pregnancies have a lower gestational age at birth.