Dizygotic twin pregnancies after medically assisted reproduction and after natural conception: maternal and perinatal outcomes

Alexandra J. Bensdorp, Chantal W. Hukkelhoven, Fulco van der Veen, Ben W J Mol, Cornelis B. Lambalk, Madelon van Wely

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective To compare maternal and perinatal outcomes in dizygotic twin pregnancies conceived after medically assisted reproduction (MAR) with outcomes after natural conception (NC). Design Nationwide registry based study. Setting Academic medical center. Patient(s) Primiparous women who delivered opposite sex twins between January 2000 and December 2012 in the Netherlands, comprising dizygotic twin pregnancies: 6,694 women, 470 after ovulation induction (OI), 511 after intrauterine insemination with controlled ovarian hyperstimulation (IUI-COH), 2,437 after in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI), and 3,276 after NC. Intervention(s) None. Main Outcome Measure(s) Multivariable logistic regression and generalized linear mixed models to evaluate differences in outcomes: maternal outcomes of hypertension, preeclampsia, preterm delivery, hemorrhage, and delivery mode, perinatal outcomes including small for gestational age (SGA) with birth weight <10th percentile, birth weight <1,500 g, 5-minute Apgar score <7, admission to neonatal intensive care unit, congenital anomalies, and perinatal mortality. Result(s) We found no statistically significant differences in maternal or perinatal outcomes after OI compared with NC. Women pregnant after IVF-ICSI had a lower risk for hypertension (adjusted odds ratio [aOR] 0.74; 95% confidence interval [CI], 0.66–0.83) compared with women pregnant after NC. After IUI-COH more children had Apgar scores <7 (adjusted odds ratio (aOR) 1.38; 95% confidence interval (CI) 1.05–1.81) and perinatal mortality rates were higher (aOR 1.56; 95% CI, 1.04–2.33) compared with NC. We found no differences in perinatal outcomes after IVF-ICSI compared with NC. Conclusion(s) Overall, maternal and perinatal risks other than those due to multiplicity are similar for twin pregnancies conceived after MAR and after NC.

LanguageEnglish
Pages371-377.e2
JournalFertility and Sterility
Volume106
Issue number2
DOIs
Publication statusPublished - 1 Aug 2016

Keywords

  • Intrauterine insemination
  • in vitro fertilization
  • natural conception
  • ovulation induction
  • twin pregnancy

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

Cite this

Bensdorp, A. J., Hukkelhoven, C. W., van der Veen, F., Mol, B. W. J., Lambalk, C. B., & van Wely, M. (2016). Dizygotic twin pregnancies after medically assisted reproduction and after natural conception: maternal and perinatal outcomes. Fertility and Sterility, 106(2), 371-377.e2. https://doi.org/10.1016/j.fertnstert.2016.03.042
Bensdorp, Alexandra J. ; Hukkelhoven, Chantal W. ; van der Veen, Fulco ; Mol, Ben W J ; Lambalk, Cornelis B. ; van Wely, Madelon. / Dizygotic twin pregnancies after medically assisted reproduction and after natural conception : maternal and perinatal outcomes. In: Fertility and Sterility. 2016 ; Vol. 106, No. 2. pp. 371-377.e2.
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Dizygotic twin pregnancies after medically assisted reproduction and after natural conception : maternal and perinatal outcomes. / Bensdorp, Alexandra J.; Hukkelhoven, Chantal W.; van der Veen, Fulco; Mol, Ben W J; Lambalk, Cornelis B.; van Wely, Madelon.

In: Fertility and Sterility, Vol. 106, No. 2, 01.08.2016, p. 371-377.e2.

Research output: Contribution to journalArticle

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T1 - Dizygotic twin pregnancies after medically assisted reproduction and after natural conception

T2 - Fertility and Sterility

AU - Bensdorp, Alexandra J.

AU - Hukkelhoven, Chantal W.

AU - van der Veen, Fulco

AU - Mol, Ben W J

AU - Lambalk, Cornelis B.

AU - van Wely, Madelon

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AB - Objective To compare maternal and perinatal outcomes in dizygotic twin pregnancies conceived after medically assisted reproduction (MAR) with outcomes after natural conception (NC). Design Nationwide registry based study. Setting Academic medical center. Patient(s) Primiparous women who delivered opposite sex twins between January 2000 and December 2012 in the Netherlands, comprising dizygotic twin pregnancies: 6,694 women, 470 after ovulation induction (OI), 511 after intrauterine insemination with controlled ovarian hyperstimulation (IUI-COH), 2,437 after in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI), and 3,276 after NC. Intervention(s) None. Main Outcome Measure(s) Multivariable logistic regression and generalized linear mixed models to evaluate differences in outcomes: maternal outcomes of hypertension, preeclampsia, preterm delivery, hemorrhage, and delivery mode, perinatal outcomes including small for gestational age (SGA) with birth weight <10th percentile, birth weight <1,500 g, 5-minute Apgar score <7, admission to neonatal intensive care unit, congenital anomalies, and perinatal mortality. Result(s) We found no statistically significant differences in maternal or perinatal outcomes after OI compared with NC. Women pregnant after IVF-ICSI had a lower risk for hypertension (adjusted odds ratio [aOR] 0.74; 95% confidence interval [CI], 0.66–0.83) compared with women pregnant after NC. After IUI-COH more children had Apgar scores <7 (adjusted odds ratio (aOR) 1.38; 95% confidence interval (CI) 1.05–1.81) and perinatal mortality rates were higher (aOR 1.56; 95% CI, 1.04–2.33) compared with NC. We found no differences in perinatal outcomes after IVF-ICSI compared with NC. Conclusion(s) Overall, maternal and perinatal risks other than those due to multiplicity are similar for twin pregnancies conceived after MAR and after NC.

KW - Intrauterine insemination

KW - in vitro fertilization

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KW - ovulation induction

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