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Spontan ve invitro fetilizasyon (IVF) ikiz gebeliklerin obstetrik ve perinatal sonuçlarının karşılaştırılması

Yıl 2022, , 228 - 233, 26.09.2022
https://doi.org/10.47582/jompac.1163541

Öz

Amaç: Spontan ikiz gebelikler ile invitro fertilizasyon (İVF) yöntemi ile gerçekleşen ikiz gebeliklerin perinatal ve obstetrik sonuçlarını karşılaştırmayı ve analiz etmeyi amaçladık.
Gereç ve Yöntem: Ocak 2016-Ocak 2021 tarihleri arasında üçüncü basamak perinatoloji merkezinde İVF yöntemiyle veya spontan şekilde gerçekleşen ikiz gebeler retrospektif olarak çalışmaya dahil edildi. Gebelerin demografik verileri (cinsiyet, yaş, gebelik haftası) ve doğum şekilleri (spontan ve İVF) analiz edildi. Gebelerde görülen erken membran yırtılması (EMR), preterm doğum (PD) ve intrauterin büyüme geriliği (IUBG) sıklıkları kaydedildi. Ayrıca apgar skorları, fetal anomalilerin varlığı, yenidoğan yoğun bakım (YYB) ihtiyacı ve mortalite oranları analiz edildi.
Bulgular: Toplam 261 ikiz gebe çalışmaya dahil edildi. Ortanca yaş 29 (en az 15-en fazla 40 yıl) ve %23,8 ‘i ≥35 yaşındaydı. Spontan ve IVF gebelik oranları, sırasıyla, %75,9 ve %24,1 idi. İkiz gebeliklerde en sık görülen sorunlar sırasıyla EMR (%14,6), PD (%13,4), GHT (%11,5), oligohidramnios (%6,1), GDM (%4,6) ve polihidramnios (%2,3) idi. Ayrıca %13,8’inde IUBG vardı. IVF gebelerin ortanca yaşı, spontan gebelere göre anlamlı derecede daha yüksekti (33,0-28,0) (p<0,001). Preterm doğum olan gebelerde gebelik yaşı, PD olmayanlara göre anlamlı olarak daha yüksek bulundu (p=0,009). IVF yönetiyle gerçekleşen ikiz gebeliklerde EMR ve PD insidansı spontan gebeliklere göre daha yüksekti (sırasıyla p<0.001 ve p<0.001). İkiz bebeklerin postnatal 1-5. dakika Apgar skorları IVF grubunda daha düşüktü (p<0,001).Bebeklerin yarısından fazlasında YYB ihtiyacı mevcuttu ve bu oran IVF grubunda spontan gruba göre anlamlı olarak daha yüksekti (%71,4-%50,5) (p=0,004).
Sonuç: IVF ikiz gebelikleri EMR ve PD açısından riskli gebeliklerdir. Ayrıca, IVF ikizlerinde YYB ihtiyacı spontan ikiz bebeklere göre daha yüksektir.

Kaynakça

  • Osterman MJK, Hamilton BE, Martin JA, et al. Births: final data for 2020. Natl Vital Stat Rep 2022; 70: 1.
  • A B, M K. Outcome of twin pregnancies conceived after assisted reproductive techniques. J Hum Reprod Sci 2008; 1: 25-8.
  • Kulkarni AD, Jamieson DJ, Jones HW Jr, et al. Fertility treatments and multiple births in the United States. N Engl J Med 2013; 369: 2218-25.
  • Cagliyan E, Saridas Demir S, Ozmen S, et al. Comparison of obstetric and perinatal outcomes after in vitro fertilization (IVF) and spontaneous dichorionic diamniotic twin pregnancies. TJRMS 2020; 4: 73-7.
  • Rao A, Sairam S, Shehata H. Obstetric complications of twin pregnancies. Best Pract Res Clin Obstet Gynaecol 2004; 18: 557-76.
  • Okby R, Harlev A, Sacks KN, Sergienko R, Sheiner E. Preeclampsia acts differently in in vitro fertilization versus spontaneous twins. Arch Gynecol Obstet 2018; 297: 653-8.
  • Pinborg A, Loft A, Rasmussen S, et al. Neonatal outcome in a Danish national cohort of 3438 IVF/ICSI and 10,362 non-IVF/ICSI twins born between 1995 and 2000. Hum Reprod 2004; 19: 435-41.
  • Helmerhorst FM, Perquin DA, Donker D, Keirse MJ. Perinatal outcome of singletons and twins after assisted conception: a systematic review of controlled studies. BMJ 2004 31; 328: 261.
  • Hack KEA, Vereycken MEMS, Torrance HL, Koopman-Esseboom C, Derks JB. Perinatal outcome of monochorionic and dichorionic twins after spontaneous and assisted conception: a retrospective cohort study. Acta Obstet Gynecol Scand 2018; 97: 717-26.
  • Gluck O, Mizrachi Y, Bar J, Barda G. The impact of advanced maternal age on the outcome of twin pregnancies. Arch Gynecol Obstet 2018; 297: 891-95.
  • Tandulwadkar SR, Lodha PA, Mangeshikar NT. Obstetric complications in women with IVF conceived pregnancies and polycystic ovarian syndrome. J Hum Reprod Sci 2014; 7: 13-8.
  • Hack KEA, Vereycken MEMS, Torrance HL, Koopman-Esseboom C, Derks JB. Perinatal outcome of monochorionic and dichorionic twins after spontaneous and assisted conception: a retrospective cohort study. Acta Obstet Gynecol Scand 2018; 97: 717-26.
  • Bardis N, Maruthini D, Balen AH. Modes of conception and multiple pregnancy: a national survey of babies born during one week in 2003 in the United Kingdom. Fertil Steril 2005 84: 1727-32.
  • Evren Güler A, Pehlivan H, Korucuoğlu Ü, Çakmak B, Şahin S, Asyalı Biri A. Spontan ve yardımcı üreme tekniği ile oluşan i̇kiz gebeliklerin perinatal sonuçları. Gaziosmanpaşa Tıp Derg 2016; 8: 256-62.
  • Wang AY, Safi N, Ali F, et al. Neonatal outcomes among twins following assisted reproductive technology: an Australian population-based retrospective cohort study. BMC Pregnancy Childbirth 2018; 18: 320.
  • Ozcil MD. Comparison of feto-maternal effects of twin pregnancies and twin pregnancies caused by assisted reproductive technology. J Acad Res Med 2021; 11: 17-23
  • Ananth CV, Chauhan SP. Epidemiology of twinning in developed countries. Semin Perinatol 2012; 36: 156-61.
  • Bordi G, D’Ambrosio A, Gallotta I, et al. The influence of ovulation induction and assisted conception on maternal and perinatal outcomes of twin pregnancies. Eur Rev Med Pharmacol Sci 2017; 21: 3998-4006.
  • Rufat P, Olivennes F, de Mouzon J, Dehan M, Frydman R. Task force report on the outcome of pregnancies and children conceived by in vitro fertilization (France: 1987 to 1989). Fertil Steril 1994; 61: 324-30.
  • Dhont M, De Neubourg F, Van der Elst J, De Sutter P. Perinatal outcome of pregnancies after assisted reproduction: a case-control study. J Assist Reprod Genet 1997; 14: 575-80.
  • Lin D, Li P, Fan D, et al. Association between IVF/ICSI treatment and preterm birth and major perinatal outcomes among dichorionic-diamnionic twin pregnancies: A seven-year retrospective cohort study. Acta Obstet Gynecol Scand 2021; 100: 162-9.
  • Chen H, Wan Y, Xi H, et al. Obstetric and perinatal outcomes of dizygotic twin pregnancies resulting from in vitro fertilization versus spontaneous conception: a retrospective study. PeerJ 2019 1; 7: e6638.
  • Harlev A, Walfisch A, Oran E, et al. The effect of fertility treatment on adverse perinatal outcomes in women aged at least 40 years. Int J Gynaecol Obstet 2018; 140: 98-104.
  • Farhi J, Ben-Haroush A, Andrawus N, et al. High serum oestradiol concentrations in IVF cycles increase the risk of pregnancy complications related to abnormal placentation. Reprod Biomed Online 2010; 21: 331-7.
  • Yelland LN, Schuit E, Zamora J, et al. Correlation between neonatal outcomes of twins depends on the outcome: secondary analysis of twelve randomised controlled trials. BJOG 2018; 125: 1406-13.
  • Zegers-Hochschild F, Schwarze JE, Crosby JA, Musri C, Urbina MT; Latin American Network of Assisted Reproduction (REDLARA). Assisted reproductive techniques in Latin America: the Latin American Registry, 2013. Reprod Biomed Online 2016; 32: 614-25.
  • Tosun Öİ, Karatoprak EY, Ovalı F. An assessment and postnatal cost analysis of multiple pregnancies after assisted reproductive techniques. Anatol Clin 2018; 23: 177-82.
  • Barda G, Gluck O, Mizrachi Y, Bar J. A comparison of maternal and perinatal outcome between in vitro fertilization and spontaneous dichorionic-diamniotic twin pregnancies. J Matern Fetal Neonatal Med 2017 ; 30: 2974-2977.
  • Pinzauti S, Ferrata C, Vannuccini S, et al. Twin pregnancies after assisted reproductive technologies: the role of maternal age on pregnancy outcome. Eur J Obstet Gynecol Reprod Biol 2016; 206: 198-203.
  • Di Tommaso M, Sisti G, Colombi I, et al. Influence of assisted reproductive technologies on maternal and neonatal outcomes in early preterm deliveries. J Gynecol Obstet Hum Reprod 2019; 48: 845-8.
  • Yaşar BN, Terzioğlu F. Perinatal outcomes in assisted reproductive techniques. Anadolu Hemşirelik ve Sağlık Bilimleri Derg 2016; 19: 139-44.
  • Biri A, Korucuoğlu Ü. Yardımcı üreme teknikleri sonrası perinatal sonuçlar. Turkiye Klinikleri J Surg Med Sci 2007; 3: 91-101.
  • Sumer D, Cetin M, Yenicesu AG, Yanik A. Comparison of obstetric and perinatal outcomes of spontaneous or IVF twin pregnancies. Cumhuriyet Med J 2013; 35: 526-31.
  • Aslan H, Gul A, Cebeci A, Polat I, Ceylan Y. The outcome of twin pregnancies complicated by single fetal death after 20 weeks of gestation. Twin Res 2004; 7: 1-4.
  • McDonald S, Murphy K, Beyene J, Ohlsson A. Perinatal outcomes of in vitro fertilization twins: a systematic review and meta-analyses. Am J Obstet Gynecol 2005; 193: 141-52.
  • Vasario E, Borgarello V, Bossotti C, et al. IVF twins have similar obstetric and neonatal outcome as spontaneously conceived twins: a prospective follow-up study. Reprod Biomed Online 2010; 21: 422-8.

A comparison of obstetric and perinatal outcomes of spontaneous and in vitro fertilization (IVF) twin pregnancies

Yıl 2022, , 228 - 233, 26.09.2022
https://doi.org/10.47582/jompac.1163541

Öz

Aim: We aimed to compare and analyze the perinatal and obstetric outcomes of in vitro fertilization (IVF) method and spontaneous twin pregnancies.
Material and Method: Pregnant women who had had IVF and those with spontaneous fertilization in a tertiary perinatology center between January 2016 and January 2021 were retrospectively included in this study. The demographic data of the women (gender, age, gestational week) and fertilization types (spontaneous or IVF) were analyzed. Premature rupture of membranes (PROM), preterm delivery (PD), and intrauterine growth restriction (IUGR) was recorded. Additionally, Apgar scores, the presence of fetal anomalies, the need for neonatal intensive care (NICU) and mortality were analyzed.
Results: Overall, 261 women who were pregnant with twins were included in this study. The median age of the mothers was 29 years (min 15-max 40 years), and 23.8% were ≥35 years. Spontaneous and IVF pregnancies occurred in 75.9% and 24.1%, respectively. The most common problems in the twin pregnancies were PROM (14.6%), PD (13.4%), GHT (11.5%), oligohydramnios (6.1%), GDM (4.6%), and polyhydramnios (2.3%). Also, 13.8% had IUGR. The median age of the women with IVF pregnancies was higher than the spontaneous pregnancies (33.0 vs 28.0 years) (p<0.001). The maternal age was found to be significantly higher in those women with PD compared to those without PD (33.0 vs 28.0 years) (p=0.009). The incidence of PROM and the rate of PD were significantly higher in the IVF pregnancies group compared to the spontaneous pregnancies group (p<0.001 and p<0.001, respectively). The postnatal 1st and 5th minute Apgar scores of the twin babies were significantly lower in the IVF group (p<0.001). Over the half of babies needed NICU and this rate was significantly higher in the IVF group compared to the spontaneous pregnancy group (71.4% vs 50.5%) (p=0.004).
Conclusion: IVF twin pregnancies are risky pregnancies in terms of PROM and PD. Additionally, the need for NICU is higher for IVF twin birth pregnancies than for spontaneous twin pregnancies.

Kaynakça

  • Osterman MJK, Hamilton BE, Martin JA, et al. Births: final data for 2020. Natl Vital Stat Rep 2022; 70: 1.
  • A B, M K. Outcome of twin pregnancies conceived after assisted reproductive techniques. J Hum Reprod Sci 2008; 1: 25-8.
  • Kulkarni AD, Jamieson DJ, Jones HW Jr, et al. Fertility treatments and multiple births in the United States. N Engl J Med 2013; 369: 2218-25.
  • Cagliyan E, Saridas Demir S, Ozmen S, et al. Comparison of obstetric and perinatal outcomes after in vitro fertilization (IVF) and spontaneous dichorionic diamniotic twin pregnancies. TJRMS 2020; 4: 73-7.
  • Rao A, Sairam S, Shehata H. Obstetric complications of twin pregnancies. Best Pract Res Clin Obstet Gynaecol 2004; 18: 557-76.
  • Okby R, Harlev A, Sacks KN, Sergienko R, Sheiner E. Preeclampsia acts differently in in vitro fertilization versus spontaneous twins. Arch Gynecol Obstet 2018; 297: 653-8.
  • Pinborg A, Loft A, Rasmussen S, et al. Neonatal outcome in a Danish national cohort of 3438 IVF/ICSI and 10,362 non-IVF/ICSI twins born between 1995 and 2000. Hum Reprod 2004; 19: 435-41.
  • Helmerhorst FM, Perquin DA, Donker D, Keirse MJ. Perinatal outcome of singletons and twins after assisted conception: a systematic review of controlled studies. BMJ 2004 31; 328: 261.
  • Hack KEA, Vereycken MEMS, Torrance HL, Koopman-Esseboom C, Derks JB. Perinatal outcome of monochorionic and dichorionic twins after spontaneous and assisted conception: a retrospective cohort study. Acta Obstet Gynecol Scand 2018; 97: 717-26.
  • Gluck O, Mizrachi Y, Bar J, Barda G. The impact of advanced maternal age on the outcome of twin pregnancies. Arch Gynecol Obstet 2018; 297: 891-95.
  • Tandulwadkar SR, Lodha PA, Mangeshikar NT. Obstetric complications in women with IVF conceived pregnancies and polycystic ovarian syndrome. J Hum Reprod Sci 2014; 7: 13-8.
  • Hack KEA, Vereycken MEMS, Torrance HL, Koopman-Esseboom C, Derks JB. Perinatal outcome of monochorionic and dichorionic twins after spontaneous and assisted conception: a retrospective cohort study. Acta Obstet Gynecol Scand 2018; 97: 717-26.
  • Bardis N, Maruthini D, Balen AH. Modes of conception and multiple pregnancy: a national survey of babies born during one week in 2003 in the United Kingdom. Fertil Steril 2005 84: 1727-32.
  • Evren Güler A, Pehlivan H, Korucuoğlu Ü, Çakmak B, Şahin S, Asyalı Biri A. Spontan ve yardımcı üreme tekniği ile oluşan i̇kiz gebeliklerin perinatal sonuçları. Gaziosmanpaşa Tıp Derg 2016; 8: 256-62.
  • Wang AY, Safi N, Ali F, et al. Neonatal outcomes among twins following assisted reproductive technology: an Australian population-based retrospective cohort study. BMC Pregnancy Childbirth 2018; 18: 320.
  • Ozcil MD. Comparison of feto-maternal effects of twin pregnancies and twin pregnancies caused by assisted reproductive technology. J Acad Res Med 2021; 11: 17-23
  • Ananth CV, Chauhan SP. Epidemiology of twinning in developed countries. Semin Perinatol 2012; 36: 156-61.
  • Bordi G, D’Ambrosio A, Gallotta I, et al. The influence of ovulation induction and assisted conception on maternal and perinatal outcomes of twin pregnancies. Eur Rev Med Pharmacol Sci 2017; 21: 3998-4006.
  • Rufat P, Olivennes F, de Mouzon J, Dehan M, Frydman R. Task force report on the outcome of pregnancies and children conceived by in vitro fertilization (France: 1987 to 1989). Fertil Steril 1994; 61: 324-30.
  • Dhont M, De Neubourg F, Van der Elst J, De Sutter P. Perinatal outcome of pregnancies after assisted reproduction: a case-control study. J Assist Reprod Genet 1997; 14: 575-80.
  • Lin D, Li P, Fan D, et al. Association between IVF/ICSI treatment and preterm birth and major perinatal outcomes among dichorionic-diamnionic twin pregnancies: A seven-year retrospective cohort study. Acta Obstet Gynecol Scand 2021; 100: 162-9.
  • Chen H, Wan Y, Xi H, et al. Obstetric and perinatal outcomes of dizygotic twin pregnancies resulting from in vitro fertilization versus spontaneous conception: a retrospective study. PeerJ 2019 1; 7: e6638.
  • Harlev A, Walfisch A, Oran E, et al. The effect of fertility treatment on adverse perinatal outcomes in women aged at least 40 years. Int J Gynaecol Obstet 2018; 140: 98-104.
  • Farhi J, Ben-Haroush A, Andrawus N, et al. High serum oestradiol concentrations in IVF cycles increase the risk of pregnancy complications related to abnormal placentation. Reprod Biomed Online 2010; 21: 331-7.
  • Yelland LN, Schuit E, Zamora J, et al. Correlation between neonatal outcomes of twins depends on the outcome: secondary analysis of twelve randomised controlled trials. BJOG 2018; 125: 1406-13.
  • Zegers-Hochschild F, Schwarze JE, Crosby JA, Musri C, Urbina MT; Latin American Network of Assisted Reproduction (REDLARA). Assisted reproductive techniques in Latin America: the Latin American Registry, 2013. Reprod Biomed Online 2016; 32: 614-25.
  • Tosun Öİ, Karatoprak EY, Ovalı F. An assessment and postnatal cost analysis of multiple pregnancies after assisted reproductive techniques. Anatol Clin 2018; 23: 177-82.
  • Barda G, Gluck O, Mizrachi Y, Bar J. A comparison of maternal and perinatal outcome between in vitro fertilization and spontaneous dichorionic-diamniotic twin pregnancies. J Matern Fetal Neonatal Med 2017 ; 30: 2974-2977.
  • Pinzauti S, Ferrata C, Vannuccini S, et al. Twin pregnancies after assisted reproductive technologies: the role of maternal age on pregnancy outcome. Eur J Obstet Gynecol Reprod Biol 2016; 206: 198-203.
  • Di Tommaso M, Sisti G, Colombi I, et al. Influence of assisted reproductive technologies on maternal and neonatal outcomes in early preterm deliveries. J Gynecol Obstet Hum Reprod 2019; 48: 845-8.
  • Yaşar BN, Terzioğlu F. Perinatal outcomes in assisted reproductive techniques. Anadolu Hemşirelik ve Sağlık Bilimleri Derg 2016; 19: 139-44.
  • Biri A, Korucuoğlu Ü. Yardımcı üreme teknikleri sonrası perinatal sonuçlar. Turkiye Klinikleri J Surg Med Sci 2007; 3: 91-101.
  • Sumer D, Cetin M, Yenicesu AG, Yanik A. Comparison of obstetric and perinatal outcomes of spontaneous or IVF twin pregnancies. Cumhuriyet Med J 2013; 35: 526-31.
  • Aslan H, Gul A, Cebeci A, Polat I, Ceylan Y. The outcome of twin pregnancies complicated by single fetal death after 20 weeks of gestation. Twin Res 2004; 7: 1-4.
  • McDonald S, Murphy K, Beyene J, Ohlsson A. Perinatal outcomes of in vitro fertilization twins: a systematic review and meta-analyses. Am J Obstet Gynecol 2005; 193: 141-52.
  • Vasario E, Borgarello V, Bossotti C, et al. IVF twins have similar obstetric and neonatal outcome as spontaneously conceived twins: a prospective follow-up study. Reprod Biomed Online 2010; 21: 422-8.
Toplam 36 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Research Articles [en] Araştırma Makaleleri [tr]
Yazarlar

Necdet Öncü

Nazlı Korkmaz

Yayımlanma Tarihi 26 Eylül 2022
Yayımlandığı Sayı Yıl 2022

Kaynak Göster

AMA Öncü N, Korkmaz N. A comparison of obstetric and perinatal outcomes of spontaneous and in vitro fertilization (IVF) twin pregnancies. J Med Palliat Care / JOMPAC / Jompac. Eylül 2022;3(3):228-233. doi:10.47582/jompac.1163541

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