The incidence of monozygotic twinning following PGD is not increased

Author： Verpoest W. Van Landuyt L. Desmyttere S. Cremers A. Devroey P. Liebaers I.

ISSN： 1460-2350

Source： Human Reproduction, Vol.24, Iss.11, 2009-11, pp. : 2945-2950

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Abstract

BACKGROUND Monozygotic (MZ) twin pregnancies are associated with increased perinatal mortality and morbidity, and risk of congenital anomalies. The causes of MZ twinning in humans are unclear but the incidence may increase after PGD, for example, as a result of holes created in the zona pellucida. We compared the incidence of MZ twin pregnancies in ICSI cycles with PGD, versus ICSI cycles without PGD. METHODS In this retrospective comparative cohort study, we analysed incidence of twin pregnancies in unselected patients undergoing ICSI and PGD (group A; 1992 cycles) with blastocyst transfer at Day 5, versus a period-matched control population of unselected patients undergoing ICSI and blastocyst transfer at Day 5 without PGD (group B; 2429 cycles) from January 2001 to December 2006. RESULTS Clinical pregnancy per embryo transfer was established in 618/1992 (31.0) and 947/2429 (39.0) in group A versus B, respectively (P < 0.01).="" overall="" mz="" twin="" rate="" was="" 29/4421="" (0.7)="" per="" embryo="" transfer="" and="" 29/1565="" (1.9)="" per="" established="" clinical="" pregnancy.="" the="" incidence="" of="" mz="" twinning="" per="" established="" clinical="" pregnancy="" did="" not="" differ="" between="" groups="" (1.5="" versus="" 2.1,="" group="" a="" and="" b,="" respectively).="" in="" group="" a,="" seven="" mz="" twins="" were="" born="" versus="" 19="" mz="" twins="" in="" group="" b.="" in="" group="" b,="" one="" mz="" twin="" pregnancy="" resulted="" in="" two="" stillbirths.="" in="" group="" a,="" two="" mz="" twins="" had="" severe="" congenital="" malformations="" versus="" none="" in="" group=""> CONCLUSIONS The incidence of MZ twinning was not increased in PGD compared with regular ICSI with blastocyst transfer. This information is useful in counselling patients about potential risks of PGD.