Monozygotic twinning: an eight-year experience at a large IVF center

Jaime Knopman, Lewis C. Krey, Jennifer Lee, Mary Elizabeth Fino, Akiva P Novetsky, Nicole Noyes

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Objective: To characterize incidence, chorionicity, amnionicity, and pregnancy outcome for monozygotic twin pregnancy (MZT) after IVF. Design: Retrospective review. Setting: University-based fertility center. Patient(s): Autologous and oocyte donation IVF cycles eventuating in 4,976 clinical gestations from 2000 to 2007. Intervention(s): None. Main Outcome Measure(s): MZT incidence, chorionicity, zygosity, pregnancy outcome. Result(s): Ninety-eight MZTs were diagnosed after first-trimester ultrasound evaluation (2% incidence). The incidence in cycles transfering autologous oocytes was 1.7% but was 3.3% with donor oocytes; however, women <35 years old using their own oocytes displayed a similar rate (3.1%) to women using donor oocytes. Eighty MZTs occurred after fresh day-5 transfer; only 14 followed fresh day-3 transfer (2.6% vs. 1.2%). The MZT incidence in day-3 transfers without hatching was not different from those with hatching (1.3% vs. 1.1%). In addition, MZT incidence did not differ significantly whether or not ICSI was performed (2.4% vs. 2.0%). Four MZTs occurred after frozen-thawed embryo transfer (0.8% incidence). Ninety-five percent of all placental arrangements were confirmed as monochorionic-diamniotic on obstetric ultrasounds. Conclusion(s): These findings confirm a higher incidence of MZT after IVF. Monochorionic-diamniotic implantations were increased, whereas monochorionic-monoamniotic were not. The MZT risk factors included young age and extended culture, but not zona penetration or cryopreservation.

Original languageEnglish (US)
Pages (from-to)502-510
Number of pages9
JournalFertility and Sterility
Volume94
Issue number2
DOIs
StatePublished - Jul 2010
Externally publishedYes

Fingerprint

Monozygotic Twinning
Twin Pregnancy
Monozygotic Twins
Incidence
Oocytes
Pregnancy Outcome
Oocyte Donation
Tissue Donors
Intracytoplasmic Sperm Injections
Embryo Transfer
Cryopreservation
Herpes Zoster
First Pregnancy Trimester
Obstetrics
Fertility
Outcome Assessment (Health Care)

Keywords

  • amnionicity
  • blastocyst
  • chorionicity
  • high risk pregnancy
  • Monozygotic pregnancy
  • twinning

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Knopman, J., Krey, L. C., Lee, J., Fino, M. E., Novetsky, AP., & Noyes, N. (2010). Monozygotic twinning: an eight-year experience at a large IVF center. Fertility and Sterility, 94(2), 502-510. https://doi.org/10.1016/j.fertnstert.2009.03.064

Monozygotic twinning : an eight-year experience at a large IVF center. / Knopman, Jaime; Krey, Lewis C.; Lee, Jennifer; Fino, Mary Elizabeth; Novetsky, Akiva P; Noyes, Nicole.

In: Fertility and Sterility, Vol. 94, No. 2, 07.2010, p. 502-510.

Research output: Contribution to journalArticle

Knopman, J, Krey, LC, Lee, J, Fino, ME, Novetsky, AP & Noyes, N 2010, 'Monozygotic twinning: an eight-year experience at a large IVF center', Fertility and Sterility, vol. 94, no. 2, pp. 502-510. https://doi.org/10.1016/j.fertnstert.2009.03.064
Knopman, Jaime ; Krey, Lewis C. ; Lee, Jennifer ; Fino, Mary Elizabeth ; Novetsky, Akiva P ; Noyes, Nicole. / Monozygotic twinning : an eight-year experience at a large IVF center. In: Fertility and Sterility. 2010 ; Vol. 94, No. 2. pp. 502-510.
@article{08b229acaf9148759aa89218ddb06691,
title = "Monozygotic twinning: an eight-year experience at a large IVF center",
abstract = "Objective: To characterize incidence, chorionicity, amnionicity, and pregnancy outcome for monozygotic twin pregnancy (MZT) after IVF. Design: Retrospective review. Setting: University-based fertility center. Patient(s): Autologous and oocyte donation IVF cycles eventuating in 4,976 clinical gestations from 2000 to 2007. Intervention(s): None. Main Outcome Measure(s): MZT incidence, chorionicity, zygosity, pregnancy outcome. Result(s): Ninety-eight MZTs were diagnosed after first-trimester ultrasound evaluation (2{\%} incidence). The incidence in cycles transfering autologous oocytes was 1.7{\%} but was 3.3{\%} with donor oocytes; however, women <35 years old using their own oocytes displayed a similar rate (3.1{\%}) to women using donor oocytes. Eighty MZTs occurred after fresh day-5 transfer; only 14 followed fresh day-3 transfer (2.6{\%} vs. 1.2{\%}). The MZT incidence in day-3 transfers without hatching was not different from those with hatching (1.3{\%} vs. 1.1{\%}). In addition, MZT incidence did not differ significantly whether or not ICSI was performed (2.4{\%} vs. 2.0{\%}). Four MZTs occurred after frozen-thawed embryo transfer (0.8{\%} incidence). Ninety-five percent of all placental arrangements were confirmed as monochorionic-diamniotic on obstetric ultrasounds. Conclusion(s): These findings confirm a higher incidence of MZT after IVF. Monochorionic-diamniotic implantations were increased, whereas monochorionic-monoamniotic were not. The MZT risk factors included young age and extended culture, but not zona penetration or cryopreservation.",
keywords = "amnionicity, blastocyst, chorionicity, high risk pregnancy, Monozygotic pregnancy, twinning",
author = "Jaime Knopman and Krey, {Lewis C.} and Jennifer Lee and Fino, {Mary Elizabeth} and Akiva P Novetsky and Nicole Noyes",
year = "2010",
month = "7",
doi = "10.1016/j.fertnstert.2009.03.064",
language = "English (US)",
volume = "94",
pages = "502--510",
journal = "Fertility and Sterility",
issn = "0015-0282",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Monozygotic twinning

T2 - an eight-year experience at a large IVF center

AU - Knopman, Jaime

AU - Krey, Lewis C.

AU - Lee, Jennifer

AU - Fino, Mary Elizabeth

AU - Novetsky, Akiva P

AU - Noyes, Nicole

PY - 2010/7

Y1 - 2010/7

N2 - Objective: To characterize incidence, chorionicity, amnionicity, and pregnancy outcome for monozygotic twin pregnancy (MZT) after IVF. Design: Retrospective review. Setting: University-based fertility center. Patient(s): Autologous and oocyte donation IVF cycles eventuating in 4,976 clinical gestations from 2000 to 2007. Intervention(s): None. Main Outcome Measure(s): MZT incidence, chorionicity, zygosity, pregnancy outcome. Result(s): Ninety-eight MZTs were diagnosed after first-trimester ultrasound evaluation (2% incidence). The incidence in cycles transfering autologous oocytes was 1.7% but was 3.3% with donor oocytes; however, women <35 years old using their own oocytes displayed a similar rate (3.1%) to women using donor oocytes. Eighty MZTs occurred after fresh day-5 transfer; only 14 followed fresh day-3 transfer (2.6% vs. 1.2%). The MZT incidence in day-3 transfers without hatching was not different from those with hatching (1.3% vs. 1.1%). In addition, MZT incidence did not differ significantly whether or not ICSI was performed (2.4% vs. 2.0%). Four MZTs occurred after frozen-thawed embryo transfer (0.8% incidence). Ninety-five percent of all placental arrangements were confirmed as monochorionic-diamniotic on obstetric ultrasounds. Conclusion(s): These findings confirm a higher incidence of MZT after IVF. Monochorionic-diamniotic implantations were increased, whereas monochorionic-monoamniotic were not. The MZT risk factors included young age and extended culture, but not zona penetration or cryopreservation.

AB - Objective: To characterize incidence, chorionicity, amnionicity, and pregnancy outcome for monozygotic twin pregnancy (MZT) after IVF. Design: Retrospective review. Setting: University-based fertility center. Patient(s): Autologous and oocyte donation IVF cycles eventuating in 4,976 clinical gestations from 2000 to 2007. Intervention(s): None. Main Outcome Measure(s): MZT incidence, chorionicity, zygosity, pregnancy outcome. Result(s): Ninety-eight MZTs were diagnosed after first-trimester ultrasound evaluation (2% incidence). The incidence in cycles transfering autologous oocytes was 1.7% but was 3.3% with donor oocytes; however, women <35 years old using their own oocytes displayed a similar rate (3.1%) to women using donor oocytes. Eighty MZTs occurred after fresh day-5 transfer; only 14 followed fresh day-3 transfer (2.6% vs. 1.2%). The MZT incidence in day-3 transfers without hatching was not different from those with hatching (1.3% vs. 1.1%). In addition, MZT incidence did not differ significantly whether or not ICSI was performed (2.4% vs. 2.0%). Four MZTs occurred after frozen-thawed embryo transfer (0.8% incidence). Ninety-five percent of all placental arrangements were confirmed as monochorionic-diamniotic on obstetric ultrasounds. Conclusion(s): These findings confirm a higher incidence of MZT after IVF. Monochorionic-diamniotic implantations were increased, whereas monochorionic-monoamniotic were not. The MZT risk factors included young age and extended culture, but not zona penetration or cryopreservation.

KW - amnionicity

KW - blastocyst

KW - chorionicity

KW - high risk pregnancy

KW - Monozygotic pregnancy

KW - twinning

UR - http://www.scopus.com/inward/record.url?scp=77953707154&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953707154&partnerID=8YFLogxK

U2 - 10.1016/j.fertnstert.2009.03.064

DO - 10.1016/j.fertnstert.2009.03.064

M3 - Article

C2 - 19409556

AN - SCOPUS:77953707154

VL - 94

SP - 502

EP - 510

JO - Fertility and Sterility

JF - Fertility and Sterility

SN - 0015-0282

IS - 2

ER -