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Korean Journal of Obstetrics & Gynecology 1997;40(8):1586-1593.
Published online January 1, 2001.
Perinatal Outcome in Twin Pregnancies after in Vitro Fertilization and Embryo Transfer : Comparison between Reduced and Non-reduced Twins.
Myung Hee Kim, Seok Hyun Kim, Byung Chul Jee, Chang Suk Suh, Young Min Choi, Chang Jae Shin, Jung Gu Kim, Shin Yong Moon, Jin Yong Lee
Abstract
Multifetal pregnancy reduction(MFPR) has been suggested to improve pregnancy outc-ome in multifetal pregnancies with three or more fetuses after assisted reproductive techn-ology(ART) such as IVF-ET program, and now it seems to be a rather safe and effective mothod to reduce perinatal loss associated with multifetal pregnancies. To investigate the effectiveness of MFPR, the perinatal outcome of twin pregnancies in IVF-ET patients was analyzed in 3 groups : Group I-12 infertile patients who had conceived more than quadru-plet pregnancy and underwent MFPR to twin pregnancy, Group II-29 patients who had conceived triplet pregnancy and underwent MFPR to twin pregnancy, and Group III-30 pat-ients who had conceived twin pregancy initially and served as control group. Among 3 gr-oups, fetal loss rate before 24 weeks of gestation, pregnancy non-reduced, complications, gestational age at delivery, and birth weight were compared. Fetal loss rate after MFPR was significantly higher in Groups I(41.7%) and Group II(17.2%) compared with Group III(3.3%), and positively correlated with the number of fetuses before MFPR in Groups I and II. However, pregnancy complication rate was not significantly different among 3 groups(41.7%, 48.3%, and 36.7%). After exclusion of fetal loss cases before 24 weeks, mean gestational age at twin delivery and mean birth weight were not significantly different among 3 groups(36.2 weeks, 36.6 weeks, and 36.1 weeks ; 2.37 kg, 2.45 kg and 2.47kg).In conclusion, MFPR in multifetal pregnancies is an ethically justified procedure that may improve perinatal outcome in cases of multifetal pregnancies.
Key Words: Assisted reproductive technology ( ART ), In vitro fertilization and embryo transfer ( IVF-ET ), Multifetal pregnancy, Twin pregnancy, Multifetal pregnancy reduction ( MFPR ), Perinatal outcome


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