Do assisted-reproduction twin pregnancies require additional antenatal care?
E Jauniaux1, I Ben-Ami, R Maymon
1Institute for Women's Health, Royal Free and University College London Medical School, London, United Kingdom. e.jauniaux@ucl.ac.uk
Reproductive Biomedicine Online
|January 1, 2013
Summary
Assisted reproduction twins generally do not require extra care compared to spontaneous twins, especially in healthy women under 45. Risks are mainly linked to pre-existing maternal conditions, often preventable with single-embryo transfer.
Area of Science:
- Reproductive Medicine
- Obstetrics
- Perinatology
Background:
- Assisted reproduction treatments (ART) lead to iatrogenic twinning, a significant side effect.
- Twin pregnancies naturally carry higher risks than singleton pregnancies.
- Debates exist regarding the need for additional healthcare for ART twins.
Purpose of the Study:
- To evaluate the evidence for additional antenatal care requirements for ART twins compared to spontaneous twins.
- To assess specific risks associated with ART twin pregnancies.
Main Methods:
- Review of evidence on antenatal complications in assisted-reproduction twin pregnancies.
- Comparison of complication rates between ART twins and spontaneous twins.
- Analysis of risks in relation to maternal age and pre-existing medical conditions.
Main Results:
- ART twins in healthy women under 45 show no significant increase in antenatal complications compared to spontaneous twins.
- Increased risks (preterm delivery, low birthweight) are noted in ART twins with vanishing twins after 8 weeks.
- Higher rates of placenta previa and vasa previa are observed in ART twin pregnancies.
- No increased rate of fetal congenital malformations in ART twins.
- Risks are elevated in ART twins with maternal conditions like hypertension and diabetes, often avoidable with single-embryo transfer.
Conclusions:
- ART twins in healthy women under 45 generally do not require additional antenatal care.
- Specific complications in ART twins are infrequent, with limited impact on individual pregnancy outcomes.
- Pre-existing maternal conditions significantly increase risks; single-embryo transfer is recommended to mitigate these.
- ART complications are primarily technical (e.g., treatment failure, OHSS), not long-term health effects for children.
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