Comparison of twin pregnancy outcome after assisted reproductive technology with and without embryo reduction

Background: Spontaneous occurrences of multifetal pregnancies always have been a medical problem. The risks of perinatal morbidity and mortality and maternal morbidity increase with enhancement of the number of fetuses. In our prospective experimental study, the outcome of twin pregnancy after Assisted Reproductive Technologies (ART) with and without Multifetal Pregnancy Reduction (MFPR) is compared relating to perinatal and maternal complications. Objective: The aim of this study was to compare the gestational age at delivery, birth weight, and other complications of surviving twins following MFPR to those in a control group of non-reduced twins. Materials and methods: In this prospective experimental study, from infertile couples who were referred to Isfahan FertilityInfertility Center (IFIC) and were candidate for ART (Invitro Fertilization or Intra Cytoplasmic Sperm Injection), 30 couples who have had twin (control group) and 35 couples with quadruplet or higher order pregnancies (experimental group) were selected. In cases with experimental group MFPR was done, and pregnancy outcome-miscarriage, premature labor, Premature Preterm Rupture of Membranes (PPROM) and Pregnancy Induced Hypertension (PIH)-were compared between two groups. Results: Distribution of complications in experimental vs. control groups was as follows: miscarriage: 23.3 vs. 16 .7%, premature labor: 15.7% vs. 13.3 %, pregnancy induced hypertension: 13.3% vs. 16.7%, abruption: 6.7% vs. 6.7%, and premature preterm rupture of membranes: 23.3% vs. 26.7 %. Mean neonatal weight at birth (2239 vs. 2240 gr) and mean gestational age at delivery (33.5 vs. 34.1 w) were similar. The differences between two groups were not statistically significant (P>0.05). Conclusion: MFPR during early pregnancy is a safe, effective and simple operative for the purpose of reducing perinatal and maternal complications.