Open AccessIs it worth reducing twins to singletons after IVF ‐ ET ? A retrospective cohort study using propensity score matching
Author(s) -
Luo Lu,
Fan Xiongzhi,
Jie Huiying,
Gao Yong,
Chen Minghui,
Zhou Canquan,
Wang Qiong
Publication year - 2019
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.13640
Subject(s) - medicine , obstetrics , retrospective cohort study , propensity score matching , miscarriage , gestation , embryo transfer , gynecology , pregnancy , in vitro fertilisation , cohort study , singleton , surgery , biology , genetics
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.