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Acta Obstet Gynecol Scand ; 98(10): 1274-1281, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31081540

RESUMO

INTRODUCTION: Many studies have shown that multifetal reduction of high-order multiple pregnancies results in improved pregnancy outcomes. However, whether conducting elective fetal reduction from dichorionic twins after in vitro fertilization (IVF) is worthwhile remains controversial. This study aimed to determine whether elective fetal reduction of dichorionic twins after IVF and embryo transfer (IVF-ET) is associated with increased take-home baby rate. MATERIAL AND METHODS: This was a retrospective cohort study of 3600 dichorionic twin pregnancies after IVF-ET. The reduced group included 71 women with transvaginal elective fetal reduction between 7 and 8 weeks of gestation. The control group (n = 3529) comprised women who were managed expectantly. Propensity score matching was conducted before pregnancy outcomes were compared. RESULTS: The take-home baby rate was significantly lower in the reduced group (83.1% vs 92.8%, P = 0.004). The total miscarriage rate was significantly higher in the reduced group (12.7% vs 6.2%, P = 0.04). Although preterm delivery rate was lower in the reduced group (P < 0.001), over 90% were over 32 weeks, whereas the proportions were equal in the reduced group. CONCLUSIONS: In dichorionic twin pregnancies after IVF-ET, elective fetal reduction to singleton significantly decreased the chance of taking home live babies.


Assuntos
Aborto Espontâneo , Transferência Embrionária/estatística & dados numéricos , Fertilização in vitro/estatística & dados numéricos , Resultado da Gravidez , Redução de Gravidez Multifetal , Nascimento Prematuro , Aborto Espontâneo/epidemiologia , Aborto Espontâneo/etiologia , Adulto , China/epidemiologia , Estudos de Coortes , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Nascido Vivo/epidemiologia , Gravidez , Resultado da Gravidez/epidemiologia , Redução de Gravidez Multifetal/efeitos adversos , Redução de Gravidez Multifetal/métodos , Redução de Gravidez Multifetal/estatística & dados numéricos , Gravidez de Gêmeos , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/etiologia , Pontuação de Propensão , Estudos Retrospectivos , Gêmeos Dizigóticos
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