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Human Reproduction, Vol. 19, No. 2, 360-364, February 2004
© 2004 European Society of Human Reproduction and Embryology

Survival rates during the first trimester of multiple gestations achieved by ICSI: a report of 1448 consecutive multiples

Ulun Ulug1, Esra Aksoy Jozwiak1, Ali Mesut1, Mustafa Murat Berksoy1 and Mustafa Bahceci1,2,3

1 Bahceci Women Health Care Center and German Hospital at Istanbul and 2 Yeditepe University School of Medicine, Istanbul, Turkey

3 To whom correspondence should be addressed at: Azer Is Merkezi 44/17 Kat 6, Abdi Ipekci Cad, Nisantasi, 80200 Istanbul, Turkey. e-mail: mbahceci{at}superonline.com

BACKGROUND: The purpose of this study was to determine the rate of spontaneous gestational sac loss during the first trimester in women achieving multiple pregnancies by ICSI. METHODS: A retrospective analysis was performed of 1448 consecutive multiple pregnancies conceived by ICSI. RESULTS: Of the cohort of 1448 pregnancies, twin gestations constituted 59.6% (864), triplets 30.2% (438) and quadruplets 10.0% (146). During the first trimester, 69 (4.7%) patients miscarried, while 179 (12.3%) continued their pregnancies and had fewer gestational sacs at the end of the first trimester than at the beginning. The overall loss rate of any gestational sac during the first trimester in these multiple pregnancies was 10.1%. There was a significant difference in the frequency of spontaneous reduction to twin or singleton pregnancies in the first trimester between women carrying triplets (11.7%) and those carrying quadruplets (3.5%) [P = 0.004; odds ratio (OR) 3.5; 95% confidence interval (CI) 1.3–9.1]. The frequency of gestational sac loss was significantly greater among women >35 years old (20.9%) than in women less than 35 years old (15.9%) (P = 0.03; OR 1.4; 95% CI 1.0–1.9). CONCLUSION: In multiple pregnancies there is a significant risk of spontaneous loss of any embryo during the first trimester. These findings should be considered prior to any decision about selective embryo reduction.

Key words: ART/gestational sac/ICSI/multiple pregnancy/spontaneous reduction


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M. Bahceci and U. Ulug
Does underlying infertility aetiology impact on first trimester miscarriage rate following ICSI? A preliminary report from 1244 singleton gestations
Hum. Reprod., March 1, 2005; 20(3): 717 - 721.
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