title: Obstetric and perinatal outcomes of twin pregnancies conceived following IVF/ICSI treatment compared with spontaneously conceived twin pregnancies.
abstract: OBJECTIVE
  Twin pregnancy is associated with increased obstetric and perinatal risk. There are conflicting reports on whether assisted conception (ART) further increases these risks. The aim of this study is to assess the obstetric and perinatal outcomes of twin pregnancies according to mode of conception.
  
  
  METHODS
  A retrospective study of all viable dichorionic-diamniotic (DCDA) twin pregnancies (n=539) delivered at Cork University Maternity Hospital, Ireland between 2009 and 2012, divided according to spontaneous conception (SC) and ART conception, specifically IVF or ICSI.
  
  
  RESULTS
  The ART conceived group were on average 4 years older (36.8±4.23 vs 32.3±4.93 years) and more frequently nulliparous (73.7%; n=126 vs 36.1%; n=133) than their SC counterparts (p<0.001). There was no significant difference in maternal antenatal complications. ART twins were twice as likely to be delivered by caesarean section (CS) (OR 2.35; 95% CI 1.76-3.14). There was no significant difference in the rates of preterm birth or NICU admission according to mode of conception. ART conceived twins were almost twice as likely to be delivered moderately preterm (32-33(+6)) (OR 1.98, 95% CI 1.21-3.23) and were more likely to have RDS and neonatal hypoglycaemia
  
  
  CONCLUSIONS
  Twin pregnancy, irrespective of mode of conception, carries an increased risk of morbidity and mortality for both mother and babies and therefore couples should be counselled regarding the increased risk of iatrogenic twinning associated with double embryo transfer. However, for those that do conceive twins, they can be advised that assisted conception conveys no significant disadvantage over naturally conceived twin pregnancies.
authors.affiliation: Cork Fertility Centre, Fernhurst Clinic, College Road, Cork, Ireland; Anu Research Centre, Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Wilton Road, Cork, Ireland. Electronic address: minnageisler@yahoo.com.
authors.forename: Minna E
authors.initials: ME
authors.lastname: Geisler
authors.affiliation: Anu Research Centre, Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Wilton Road, Cork, Ireland.
authors.forename: Anne
authors.initials: A
authors.lastname: O'Mahony
authors.affiliation: National Perinatal Epidemiology Centre, University College Cork, Ireland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Meaney
authors.affiliation: Cork Fertility Centre, Fernhurst Clinic, College Road, Cork, Ireland.
authors.forename: John J
authors.initials: JJ
authors.lastname: Waterstone
authors.affiliation: Anu Research Centre, Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Wilton Road, Cork, Ireland.
authors.forename: Keelin
authors.initials: K
authors.lastname: O'Donoghue
mesh_terms: D000328:Adult; D001034:Apgar Score; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D005306:Fertilization; D005317:Fetal Growth Retardation / Q000453:epidemiology; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data; D007494:Ireland / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D059285:Pregnancy, Twin; D047928:Premature Birth / Q000453:epidemiology; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic
keywords: DCDA twins; In vitro fertilisation; Perinatal outcome; Spontaneous conception; Twin pregnancy