Obstetrical and perinatal complications of twin pregnancies: is there a link with the type of infertility treatment?

Abstract

Introduction: The aim of this study was to compare the maternal and perinatal data from spontaneous twin pregnancies with twin pregnancies conceived via assisted reproductive technology, and to evaluate the outcomes depending on the type of treatment.

Material and methods: A historical cohort of all twin live births between 1997 and 2014 was used to create two groups: spontaneous pregnancies and pregnancies after infertility treatment (ovulation induction, intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection). The population characteristics and pregnancy, childbirth, and neonatal complications were compared, and the data were adjusted for age, parity, chorionicity, and the mother's body mass index to assess only the impact of the infertility treatments.

Results: In total, 1580 twin pregnancies were included, with 575 requiring assisted conception. We did not observe any differences between the assisted conception pregnancies and the spontaneous twin pregnancies with regard to the obstetric and childbirth complications and neonatal outcomes. In addition, there were no statistically significant differences between the types of infertility treatment.

Conclusion: After adjusting for the maternal parameters and chorionicity, the twin pregnancies conceived via assisted reproductive technology were not at an increased risk of obstetric and neonatal complications. Moreover, the type of treatment did not alter the obstetric and neonatal complications. Therefore, the higher complication rate was related to the patient's medical specifics, rather than to the infertility treatment.

Keywords: Assisted reproductive technology; in vitro fertilization; infertility treatment; intracytoplasmic sperm injection; intrauterine insemination; ovulation induction; twin pregnancy.