Umbilical cord anomalies are more frequent in twins after assisted reproduction

Authors: Delbaere, I.; Goetgeluk, S.; Derom, C.; De Bacquer, D.; De Sutter, P.; Temmerman, M.

Source: Human Reproduction, Volume 22, Number 10, 24 October 2007 , pp. 2763-2767(5)

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Abstract:

BACKGROUND

The objective of this study is to analyse differences in cord characteristics between naturally conceived twins and twins born after assisted reproduction.

METHODS

Between 1985 and 2004, the East Flanders Prospective Twin Survey (EFPTS) registered 4159 twin pairs. We compared cord characteristics between 2119 naturally conceived dizygotic (DZ) twin members and 2243 DZ twin members originating from assisted reproductive technologies (ART). Data were adjusted for intra-twin correlation, year of birth, maternal age, gestational age, parity, sex of the child and number of placentas.

RESULTS

Marginal cord insertion, velamentous cord insertion and single umbilical artery (SUA) occur more frequently in twins following infertility treatment (P < 0.001). The incidence of velamentous cord insertion increases proportionate with invasiveness of reproductive techniques: 3.6 in naturally conceived twins versus 5 in twins after artificial induction of ovulation (AIO) [odds ratio (OR) 1.45; 95 confidence interval (CI) 0.992.11], 7.4 in twins after IVF (OR 1.49; 95 CI 1.261.77) and 10.4 in twins after ICSI (OR 1.31; 95 CI 1.141.51). SUA has the highest incidence in twins after AIO: 1.9 compared with 0.6 in naturally conceived twins (OR 3.19; 95 CI 1.666.11).

CONCLUSIONS

Umbilical cords of twins born after ART have more pathologic characteristics when compared with cords of naturally conceived twins.

Keywords: umbilical cord; assisted reproduction; implantation; multiple pregnancy

Document Type: Research article

DOI: http://dx.doi.org/10.1093/humrep/dem191

Publication date: 2007-10-24

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Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.

Umbilical cord anomalies are more frequent in twins after assisted reproduction

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