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Do assisted conception twins have an increased risk for anencephaly?
1Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, affiliated with Sackler School of Medicine, Tel-Aviv University, Zerifin 70300, Israel.
Human Reproduction (Oxford, England)
|October 11, 2011
Summary
Twin pregnancies conceived via assisted reproductive technology (ART) show a significantly increased risk for anencephaly. This suggests a synergistic effect between twinning and ART in causing this neural tube defect.
Area of Science:
- Obstetrics and Gynecology
- Reproductive Medicine
- Teratology
Background:
- Anterior neural tube defects like anencephaly and encephalocele are observed more frequently in twins than singletons.
- The underlying causes related to twinning, assisted reproductive technology (ART), or a combination thereof require investigation.
Purpose of the Study:
- To determine if the increased incidence of anencephaly in twins is linked to the mode of conception (spontaneous vs. ART) or twinning itself.
- To evaluate the combined effect of ART and twinning on anencephaly risk.
Main Methods:
- A cohort of women with suspected severe fetal abnormalities undergoing ultrasonography was analyzed.
- Pregnancies were categorized by conception mode (spontaneous vs. ART) and plurality (singleton vs. multiple).
- Anencephaly rates in the study group were compared to overall live births.
Main Results:
- Anencephaly occurred in 11.5% of twin pregnancies, with a higher rate (17.8%) in ART-conceived twins.
- Twinning significantly correlated with anencephaly (OR 3.4), while ART alone did not.
- A synergistic effect was observed between ART conception and twinning, significantly increasing anencephaly risk (OR 6.6 in the study group, OR 24.6 among all live births).
Conclusions:
- Twin pregnancies conceived through ART represent a high-risk group for anencephaly.
- A synergistic interaction between twinning and ART likely contributes to the elevated risk of anencephaly.
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