Double trouble? Clinic-specific risk factors for monozygotic twinning

To investigate clinic-specific risk factors for monozygotic twinning (MZT) using a large, electronic database. Retrospective case-control study. Infertility clinics. Using an electronic medical record system, viable clinical pregnancy (confirmation of a gestational sac(s) and presence of at least on...

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Bibliographic Details
Published in:Fertility and sterility 2020-09, Vol.114 (3), p.587-594
Main Authors: Vaughan, Denis A., Seidler, Emily A., Murphy, Lauren A., Cleary, Ekaterina G., Penzias, Alan, Norwitz, Errol R., Sakkas, Denny
Format: Article
Language:English
Subjects:
Adult
Databases, Factual
Female
Fertility
Fertility Clinics
Humans
Infertility - diagnosis
Infertility - physiopathology
Infertility - therapy
IVF
Monozygotic
Practice Patterns, Physicians
Pregnancy
Pregnancy, Twin
Reproductive Techniques, Assisted - adverse effects
Retrospective Studies
Risk Assessment
Risk Factors
Treatment Outcome
twinning
Twinning, Monozygotic
United States
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Summary:To investigate clinic-specific risk factors for monozygotic twinning (MZT) using a large, electronic database. Retrospective case-control study. Infertility clinics. Using an electronic medical record system, viable clinical pregnancy (confirmation of a gestational sac(s) and presence of at least one fetal pole with a heartbeat on first trimester ultrasound), data were obtained from homologous in vitro fertilization (IVF) cycles after single ET from June 1, 2004, to December 31, 2016. Monozygotic twinning was defined as a pregnancy with two fetal heartbeats on ultrasound with sex concordance at birth. None. Risk factors for MZT including cycle type, method of insemination, and method of cryopreservation. Of the 28,265 IVF cycles that met inclusion criteria over the study period, 8,749 (31.0%) resulted in a viable intrauterine clinical pregnancy. There were 102 (2.7%) MZT in the fresh cycle cohort and 133 (2.7%) in the frozen cycle cohort. Neither cryopreservation nor the method of cryopreservation was a significant risk factor for MZT. However, the use of sequential media was an independent risk factor for MZT in fresh, but not frozen, ETs (odds ratio = 1.72, 95% confidence interval, 1.10–2.68). Significant differences were seen in the incidence of MZT between clinics, and this difference persisted after controlling for known risk factors (clinic 0, reference; clinic 2, odds ratio = 2.22; 95% confidence interval, 1.48–3.32; clinic 3, odds ratio = 1.93; 95% confidence interval, 1.30–2.87). Differences in MZT rates exist between individual IVF clinics, suggesting that variations in practice patterns may contribute to this event. The present study noted the use of sequential media was an independent risk factor for fresh but not frozen cycles. Doble problema? Factores de riesgo clínicos específicos para embarazos gemelares monozigóticos. Investigar los factores de riesgo clínicos específicos para los embarazos gemelares monozigóticos (MZT) utilizando una gran base de datos electrónica. Estudio restrospectivo de casos y controles. Clínica de Infertilidad. Utilizando un sistema electrónico de recogida de datos médicos, se recogieron los datos de los ciclos con embarazos viables clínicamente (confirmación de un saco(s) gestacional y presencia de al menos un polo fetal con latido cardiaco en la ecografía de primer trimestre), de ciclos de FIV homólogos con una TE de un único embrión entre el 1 de junio de 2004 y 31 de diciembre de 2016. El embarazo gemelar monozi
ISSN:0015-0282
1556-5653
DOI:10.1016/j.fertnstert.2020.04.010