Hum. Reprod. Advance Access originally published online on January 24, 2007
Human Reproduction 2007 22(4):1073-1079; doi:10.1093/humrep/del492
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Obstetric and neonatal outcome after single embryo transfer
1 Department of Obstetrics and Gynaecology, Helsinki University Central Hospital 2 National Research and Development Centre for Welfare and Health (STAKES), Helsinki, Finland
3 To whom correspondence should be addressed at HYKS-instituutti huone 3009/Terkko, Haartmaninkatu 4, 00290 Helsinki, Finland. Tel: +358-50-3646 534, fax: +358-9-4717 5550; E-mail: piia.poikkeus{at}hus.fi
BACKGROUND: Single embryo transfer (SET) pregnancies practically lack vanishing twins and may be associated with improved neonatal outcome. Our objective was to compare the obstetric and neonatal outcome of SET singletons with the outcome of singletons following double embryo transfer (DET) and spontaneous conception.
METHODS: A 7-year (1997–2003) cohort of fresh SET (n = 269) and DET (n = 230, including 25 vanishing twins) cycles resulting in singleton birth at Helsinki University Central Hospital, Finland, was linked to the Finnish Medical Birth Register and the obstetric and neonatal outcome data compared with that from 15 037 spontaneously conceived singleton pregnancies.
RESULTS: The obstetric and neonatal outcome of the SET group was comparable to that in the DET group. Compared with the comparison cohort, gestational hypertension (P = 0.005), placenta praevia (P < 0.001), preterm contractions (P = 0.01) and maternal hospitalization (P < 0.001) was more typical of women in the SET group. After adjusting for age, parity and socio-economic status the SET pregnancies showed increased risks of Caesarean section [odds ratio (OR) 1.54 with 95% confidence interval (CI) 1.18–2.00], preterm birth (OR 2.85; 95% CI 1.96–4.16) and low birthweight (OR 2.01; 95% CI 1.19–3.99) compared with the comparison cohort.
CONCLUSIONS: Our results indicate that subject- and infertility-related mechanisms other than the number of transferred embryos influence the neonatal outcome of singleton IVF pregnancies.
Key words: single embryo transfer/IVF/neonatal outcome/obstetric outcome/pregnancy
Submitted on July 27, 2006; resubmitted on October 24, 2006; resubmitted on November 22, 2006; accepted on December 1, 2006.
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