Abstract
Purpose: An anonymous survey of IVF centers in the United States was employed to calculate frequencies of multiple gestation, monozygotic multiple gestation, and monoamniotic multiple gestation. Rates for zona-manipulated (ICSI, SUZI, zona drilling, mechanical assisted hatching) and non-manipulated pregnancies were compared.
Results: From 42 IVF centers in the United States, a total of 143 pregnancies was ascertained from zona-manipulated cycles. A multiple gestation frequency of 16.1% was reported. Five monoamniotic twin gestations were identified: four from manipulated cycles and one from a nonmanipulated cycle. All monoamniotic twin gestations resulted in live births, although three showed significant intrauterine growth discordance and one newborn was diagnosed with the VATER malformation sequence.
Conclusions: Monoamniotic multiple gestations may be increased in zona-manipulated cycles. The potential obstetric risks and complications of zona manipulation should be discussed with patients.
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Slotnick, R.N., Ortega, J.E. Monoamniotic twinning and zona manipulation: A survey of U.S. IVF centers correlating zona manipulation procedures and high-risk twinning frequency. J Assist Reprod Genet 13, 381–385 (1996). https://doi.org/10.1007/BF02066168
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DOI: https://doi.org/10.1007/BF02066168