title: Obstetric outcome of twin pregnancies conceived by in vitro fertilization and ovulation induction compared with those conceived spontaneously.
abstract: OBJECTIVE
  To compare the obstetric characteristics of twin pregnancies conceived by in vitro fertilization (IVF) and ovulation induction with those conceived spontaneously.
  
  
  METHODS
  Case control study.
  
  
  METHODS
  Tertiary Medical Center.
  
  
  METHODS
  All twin deliveries that were achieved by IVF (n=558) and ovulation induction (n=478) from January 1988 through December 2002 were evaluated. Each group was compared with a control group that conceived spontaneously (n=3694) and was delivered during the same period.
  
  
  METHODS
  Ovulation induction, IVF-ET.
  
  
  METHODS
  Obstetrical complications.
  
  
  RESULTS
  Multivariate analysis showed that patients who conceived with the assistance of IVF and ovulation induction had a significantly higher risk for gestational diabetes mellitus (odds ratio [OR]=2.41, 95% confidence interval [CI]=1.77-3.29 and OR=1.71, CI=1.2-2.42, respectively), cesarean section (OR=2.17, 95% CI=1.74-2.70 and OR=1.76, CI=1.43-2.16, respectively), and a lower gestational age at birth in the IVF group (OR=0.91, 95% CI=0.88-0.94), compared with their controls.
  
  
  CONCLUSIONS
  After controlling for maternal age, and nulliparity we demonstrated that twin pregnancies conceived with the assistance of IVF and ovulation induction are at increased risk for gestational diabetes mellitus, and delivery by cesarean section. In addition, IVF conceived pregnancies have a lower gestational age at birth.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, PO Box 151, Beer Sheva 84101, Israel.
authors.forename: Yael
authors.initials: Y
authors.lastname: Adler-Levy
authors.forename: Eitan
authors.initials: E
authors.lastname: Lunenfeld
authors.forename: Amalia
authors.initials: A
authors.lastname: Levy
mesh_terms: D000328:Adult; D004200:Diseases in Twins / Q000453:epidemiology*; D005260:Female; D005306:Fertilization; D005307:Fertilization in Vitro; D006801:Humans; D010062:Ovulation Induction; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D014427:Twins