Clinical outcome of spontaneous pregnancy reduction of dichorionic twins after in vitro fertilization and embryo transfer

LUO Lu; DENG Ming-fen; CHEN Ming-hui; WANG Qiong; ZHOU Can-quan

doi:10.19538/j.fk2017090115

Abstract：Objective To investigate the incidence of spontaneous pregnancy reduction of dichorionic twins after in vitro fertilization and embryo transfer (IVF-ET)and its effect on pregnancy outcome.Methods A retrospective analysis of 4162 cases of dichorionic twin pregnancy after IVF-ET during 2009-2015 was conducted.Spontaneous pregnancy reduction happened in 745 cases.Totally 3661 cases of twin pregnancy without spontaneous fetal reduction were analyzed as twin control group;14521 cases with single pregnancy during the same period were analyzed as singleton control group.We described the overall incidence of spontaneous pregnancy reduction,and compare the clinical outcomes with twin control group and singleton control group;finally,through the regression model,we analyzed whether spontaneous fetal reduction was an independent risk factor of adverse pregnancy outcome.Results The overall incidence of spontaneous abortion was 17.9％,most of which occurred during early pregnancy.The miscarriage rate,premature delivery rate,live birth rate,take-home baby rate,gestational age and birth weight in fetal reduction group were significantly better than those of twin control group.The take-home baby rate,live birth rate and neonatal birth weight were not inferior to those of singleton control group.Result of regression analyses showed that twin pregnancy without spontaneous fetal reduction significantly decreased the possibility of taking baby home (OR =0.73,P=0.008).Spontaneous fetal reduction was not an independent risk factor of adverse pregnancy outcome.Conclusion Spontaneous pregnancy reduction is common in chorionic twin pregnancy after IVF-ET,which does not adversely affect the pregnancy outcome.