A Singleton IVF Pregnancy Following a Transfer of Two Embryos Is Associated With Earlier Preterm Premature Rupture of Membranes and Delivery
2Maternity “D” Department, Division of Obstetrics and Gynecology, Soroka University Medical Center
3Department of Epidemiology, Faculty of Health Sciences, Ben-Gurion University of the Negev
Introduction
Preterm delivery (PTD) is one of the complications associated with in vitro fertilization (IVF) pregnancies, yet it is unclear whether it is related to the underlying etiology leading to infertility or to the IVF treatment. In twin pregnancies, however, it is uncertain whether IVF treatment increases their background risk for PTD.
Aim
In this study we aimed to determine whether the number of implanted embryos out of those transferred, affects the obstetrical outcome, specifically regarding timing of preterm premature rupture of membranes (PPROM) and delivery.
Materials & Methods
We reviewed retrospectively the medical records of 88 women (43 singleton and 45 twin pregnancies) who conceived following an IVF treatment and had PPROM leading to PTD. The demographic characteristics, causes of infertility, treatment parameters, and obstetrical outcome were analyzed.
Results
In the whole study group, the mean gestational age at PPROM for singletons was significantly higher than twins, (33.16 ± 4.21 weeks, and 31.40 ± 3.94 weeks, respectively. p=0.046). A similar pattern was observed in the gestational age at delivery (singletons 33.81 ± 3.07 weeks, twins 31.98 ± 3.31 weeks. p=0.01). However, singleton pregnancies that followed a transfer of two embryos had a mean gestational age of PPROM and delivery similar to that of twin pregnancies (singleton 32.52 ± 4.89 weeks, twins 32.00 ± 4.12 weeks, p= 0.68).
Conclusions
Singleton pregnancies following multiple embryo transfer in IVF may represent a subpopulation of IVF patients who are prone to suffer from preterm delivery. It seems that there are common factors interfering with implantation and obstetrical complications. Our results demonstrate that transfer of more than one embryo, even if just one will implant, may influence the pregnancy outcome, hence emphasizing the importance of the decision regarding the number of embryos transferred.
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