Clinical Report
Perinatal outcome of selective fetal reduction in twin pregnancies assisted by IVF/ICSI
Ruowen Zu, Shiyu Ran, Huan Wu, Wei Zheng, Chen Yang, Shuheng Yang, Yihui Kuang, Mengna Li, Mengyi Cao, Jing Wu, Yichun Guan
Published 2023-04-25
Cite as Chin J Reprod Contracep, 2023, 43(4): 393-398. DOI: 10.3760/cma.j.cn101441-20220718-00301
Abstract
ObjectiveTo investigate the perinatal outcome of selective fetal reduction of dizygotic twins pregnancies after double embryo transferred assisted by in vitro fertilization/ intracytoplasmic sperm injection (IVF/ICSI).
MethodsThe clinical data of patients with single birth who underwent IVF/ICSI after double embryo transferred from September 1, 2005 to July 31, 2020 in Reproductive Center of the Third Affiliated Hospital of Zhengzhou University were retrospectively analyzed. The patients were divided into three groups according to the occurrence of fetal reduction: 80 cases of dizygotic twins to singleton by selective fetal reduction (group A), 832 cases of dizygotic twins to singleton by spontaneous fetal reduction (group B), and 6 178 cases of singleton (group C). Using group A as the reference, after approximately propensity score matching (PSM) with 1∶4 ratio, 289 cases in group B and 271 cases in group C were obtained. The differences in baseline data and perinatal outcomes between group A and group B or group C were analyzed.
Results1) Before PSM, there were statistically significant differences in patients' age, previous fertility history, type of infertility, and stage of embryo transferred between group A and group B or group C (all P<0.05); after PSM, there were no statistically significant differences in baseline data between group A and group B or group C (all P>0.05). 2) After PSM, the premature birth rate was higher in group A than in group B [17.5% (14/80) vs. 8.7% (25/289), P=0.023] and the gestational weeks [(38.18±1.98) weeks vs. (38.64±1.83) weeks, P=0.034] were lower; group A had higher incidence rates of premature birth [17.5% (14/80) vs. 7.7% (21/271), P=0.011] and premature rupture of membranes [5.0% (4/80) vs. 0.4% (1/271), P=0.002] than those in group C, but gestational weeks [(38.18±1.98) weeks vs. (38.85±1.47) weeks, P=0.002] and birth weight [(3 253.07±475.73) g vs. (3 384.89±479.54) g, P=0.029] were lower.
ConclusionPerinatal outcomes of selective fetal reduction of dizygotic twins pregnancies after assisted by IVF/ICSI were poor. Selective fetal reduction in multiple pregnancies is not the best remedy. The strategy of selective single embryo transfer should be adopted to effectively reduce the rate of multiple pregnancies and improve maternal and infant outcomes.
Key words:
Twins, dizygotic; Spontaneous fetal reduction; Selective fetal reduction; Perinatal outcome; Elective single embryo transfer
Contributor Information
Ruowen Zu
Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Shiyu Ran
Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Huan Wu
Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Wei Zheng
Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Chen Yang
Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Shuheng Yang
Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Yihui Kuang
Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Mengna Li
Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Mengyi Cao
Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Jing Wu
Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Yichun Guan
Reproductive Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
