[Obstetric outcome among naturally and IVF conceived twins.]

Area of Science:

• Obstetrics and Gynecology
• Reproductive Medicine
• Neonatology

Context:

• Assisted reproductive technologies, particularly in vitro fertilization (IVF), have led to an increase in twin pregnancies.
• Twin pregnancies are generally associated with higher risks compared to singleton pregnancies.
• The impact of assisted conception on obstetric management and outcomes for twin pregnancies requires further investigation.

Purpose:

• To compare obstetric management and outcomes between twin pregnancies conceived via IVF and those conceived naturally.
• To analyze differences in gestational age, delivery methods, birth weight, and neonatal care between IVF and natural twins.
• To assess perinatal mortality and wastage in twin pregnancies, distinguishing between conception methods.

Summary:

• A 1990-1993 study in Iceland identified 254 twin pregnancies, with 20.5% conceived via IVF.
• IVF twins were comparable to natural twins in gestational age and spontaneous labor onset but showed a higher rate of forceps/ventouse deliveries (p<0.02).
• Birth weights were slightly lower for IVF twins, and they had higher neonatal intensive care unit admissions, though for shorter durations; perinatal mortality was similar by conventional criteria.

Impact:

• Findings suggest that while overall perinatal mortality may not differ, IVF twins may require more intensive obstetric and neonatal interventions.
• The study highlights the need for careful obstetric management and monitoring for twin pregnancies conceived through assisted reproduction.
• Increased instrumental deliveries and neonatal admissions for IVF twins may indicate a lower threshold for intervention or specific vulnerabilities.