Management strategies for assisted reproductive technology-assisted twin pregnancies

Fan-zhen HONG

Chinese Journal of Practical Gynecology and Obstetrics ›› 2025, Vol. 41 ›› Issue (2) : 172-177.

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Chinese Journal of Practical Gynecology and Obstetrics ›› 2025, Vol. 41 ›› Issue (2) : 172-177. DOI: 10.19538/j.fk2025020109

Management strategies for assisted reproductive technology-assisted twin pregnancies

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Abstract

In recent years,with the continuous development of assisted reproductive technology and the adjustment of China's fertility policy,pregnant women are facing the trend of "advanced age",and the proportion of twin pregnancies assisted by assisted reproductive technology is also increasing. Twin pregnancies are high-risk pregnancies and are more likely to cause various obstetric comorbidities and complications than singleton pregnancies. Assisted reproductive technology(ART)-assisted twin pregnancy may be at a higher risk of adverse pregnancy outcomes due to its specificity. In order to improve the quality of perinatal care and reduce the incidence of related complications in assisted reproductive technology-assisted twin pregnancies,this article provides some key management strategies.

Key words

assisted reproductive technology / twin pregnancy / management strategies

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Fan-zhen HONG. Management strategies for assisted reproductive technology-assisted twin pregnancies[J]. Chinese Journal of Practical Gynecology and Obstetrics. 2025, 41(2): 172-177 https://doi.org/10.19538/j.fk2025020109

References

[1]
Chambers GM, Dyer S, Zegers-Hochschild F, et al. International Committee for Monitoring Assisted Reproductive Technologies world report:assisted reproductive technology,2014[J]. Hum Reprod, 2021, 36(11):2921-2934. DOI:10.1093/humrep/deab198.
[2]
Wang Y, Shi H, Chen L, et al. Absolute risk of adverse obstetric outcomes among twin pregnancies after in vitro fertilization by maternal age[J]. JAMA Netw Open, 2021, 4(9):e2123634. DOI:10.1001/jamanetworkopen.2021.23634.
[3]
国家产科专业医疗质量控制中心. 2022年国家产科医疗服务与质量安全报告[EB/OL]. (2023-04-10)[2024-12-20]. https://www.obqcc.org.cn/#/testing?id=2c9180828595dcc30187fee5d8ad0008&articleId=2c9180828595dcc301876b821ea50005.
[4]
孙贻娟, 黄国宁, 孙海翔, 等. 关于胚胎移植数目的中国专家共识[J]. 生殖医学杂志, 2018, 27(10):940-945. DOI:10.3969/j.issn.1004-3845.2018.10.003.
[5]
中华医学会生殖医学分会. 中国高龄不孕女性辅助生殖临床实践指南[J]. 中国循证医学杂志, 2019, 19(3):253-270. DOI:10.7507/1672-2531.201812103.
[6]
Grady R, Alavi N, Vale R, et a1. Elective single embryo transfer and perinatal outcomes:a systematic review and meta-analysis[J]. Fertil Steril, 2012, 97:324-331. DOI:10.1016/j.fertnstert.2011.11.033.
[7]
胡琳莉, 黄国宁, 孙海翔, 等. 多胎妊娠减胎术操作规范(2016)[J]. 生殖医学杂志, 2017, 26(3):193-198. DOI:10.3969/j.issn.1004-3845.
[8]
Zemet R, Haas J, Bart Y, et al. Optimal timing of fetal reduction from twins to singleton:earlier the better or later the better?[J]. Ultrasound Obstet Gynecol, 2021, 57(1):134-140.
[9]
中国医师协会妇产科医师分会, 中国医师协会营养医师专业委员会, 中华医学会围产医学分会. 孕前和孕期主要微量营养素补充专家共识(2024)[J]. 中华妇产科杂志, 2024, 59(10):737-746. DOI:10.3760/cma.j.cn112141-20240611-00326.
[10]
中国营养学会.T/CNSS015-2022 孕期体重增长异常妇女膳食指导[S]. 北京: 中国营养学会, 2022.
[11]
American College of Obstetricians and Gynecologists. ACOG Committee opinion no. 548:weight gain during pregnancy[J]. Obstet Gynecol, 2013, 121(1):210-212. DOI:10.1097/01.aog.0000425668.87506.4c.
[12]
Lipworth H, Barrett J, Murphy KE, et al. Gestational weight gain in twin gestations and pregnancy outcomes:a systematic review and meta-analysis[J]. BJOG, 2022, 129(6):868-879. DOI:10.1111/1471-0528.17011.
[13]
Staneva A, Bogossian F, Pritchard M, et al. The effects of maternal depression,anxiety,and perceived stress during pregnancy on preterm birth:A systematic review[J]. Women Birth, 2015, 28(3):179-193. DOI:10.1016/j.wombi.2015.02.003.
[14]
Acheampong K, Pan X, Kaminga AC, et al. Risk of adverse maternal outcomes associated with prenatal exposure to moderate-severe depression compared with mild depression:A fellow-up study[J]. J Psychiatr Res, 2021, 136:32-38. DOI:10.1016/j.jpsychires.2021.01.036.
[15]
Hjelmstedt A, Widstrom AM, Wramsby H, et al. Personality factors and emotional responses to pregnancy among IVF couples in early pregnancy:a comparative study[J]. Acta Obstet Gynecol Scand, 2003, 82(2):152-161. DOI:10.1034/j.1600-0412.2003.00040.x.
[16]
Furmli H, Seeto RA, Hewko SL, et al. Maternal mental health in assisted and natural conception:a prospective cohort study[J]. J Obstet Gynaecol Can, 2019, 41(11):1608-1615.
[17]
王予, 李骋, 刘含. 辅助生殖和自然受孕女性围产期心理健康的差异:一项前瞻性队列研究[J]. 中华生殖与避孕杂志, 2023, 43(3):269-275. DOI:10.3760/cma.j.cn101441-20211208-00547.
[18]
Aurora O, Stella T, Anne K, et al. Anxiety and depression in expectant parents:ART versus spontaneous conception[J]. Human Reproduction, 2023, 38(9):1755-1760. DOI:10.1093/humrep/dead133.
[19]
Fu W, Wilhelm LO, Wei Y, et al. Emotional intelligence and dyadic satisfaction buffer the negative effect of stress on prenatal anxiety and depressive symptoms in Chinese women who are pregnant with twins[J]. Anxiety Stress Coping, 33(4):466-478. DOI:10.1080/10615806.2020.1745193.
[20]
Omer W, Jon B, Kellie EM, et al. National and international guidelines on the management of twin pregnancies:a comparative review[J]. Am J Obstet Gynecol, 2023, 229(6):577-598. DOI:10.1016/j.ajog.2023.05.022.
[21]
Parazzini F, Cipriani S, Bianchi S, et al. Risk of monozygotic twins after assisted reproduction:a population-based approach[J]. Twin Res Hum Genet, 2016, 19(1):72-76. DOI:10.1017/thg.2015.96.
[22]
Vitthala S, Gelbaya TA, Brison DR, et al. The risk of monozygotic twins after assisted reproductive technology:a systematic review and meta-analysis[J]. Hum Reprod Update, 2009, 15(1):45-55. DOI:10.1093/humupd/dmn045.
[23]
Skiadas CC, Missmer SA, Benson CB, et al. Risk factors associated with pregnancies containing a monochorionic pair following assisted reproductive technologies[J]. Hum Reprod, 2008, 23(6):1366-1371. DOI:10.1093/humrep/den045.
[24]
泮思林, 罗刚. 推进中国胎儿结构性心脏病宫内干预的相关问题与对策[J]. 中国实用儿科杂志, 2021, 36(05):332-335.DOI:10.19538/j.ek2021050604.
[25]
Luke B, Brown MB, Wantman E, et al. The risk of birth defects with conception by ART[J]. Hum Reprod, 2021, 36(1):116-129. DOI:10.1093/humrep/deaa272.
[26]
Matthew KJ, Lisa DL, Bryann B, et al. Clinical implications of crown-rump length discordance at 11 to 14 weeks in dichorionic twins[J]. Am J Obstet Gynecol, 2024, 230(1):83.e1-83.e11. DOI:10.1016/j.ajog.2023.07.029.
[27]
ACOG Committee. Multifetal gestations:twin,triplet,and higher-order multifetal pregnancies:ACOG practice bulletin,number 231[J]. Obstet Gynecol, 2021, 137(6):e145-e162. DOI:10.1097/AOG.0000000000004397.
[28]
吴凯佳, 贾燕, 张国华, 等. 辅助生殖技术受孕对双绒毛膜双羊膜囊双胎妊娠早产发生风险的影响研究[J]. 中国实用妇科与产科杂志, 2024, 40(2):235-238.DOI:10.19538/j.fk2024020121.
[29]
Wang YP, Ray JG, Pudwell J, et al. Mode of conception and risk of spontaneous vs. provider-initiated preterm birth:population-based cohort study[J]. Fertil Steril, 2022, 118(5):926-935. DOI:10.1016/j.fertnstert.2022.07.028.
[30]
Cavoretto P, Candiani M, Giorgione V, et al. Risk of spontaneous preterm birth in singleton pregnancies conceived after IVF/ICSI treatment:meta-analysis of cohort studies[J]. Ultrasound Obstet Gynecol, 2018, 51(1):43-53. DOI:10.1002/uog.18930.
[31]
Wang L, Cheng L, Zhang S, et al. Mediation effect of pregnancy-induced hypertension on the association between assisted reproductive technology and adverse neonatal outcomes:a population-based study[J]. BMC Pregnancy Childbirth, 2023, 23(1):385. DOI:10.1186/s12884-023-05694-3.
[32]
Ban M, Sun Y, Chen X, et al. Association between maternal polycystic ovarian syndrome undergoing assisted reproductive technology and pregnancy complications and neonatal outcomes:a systematic review and meta-analysis[J]. J Ovarian Res, 2024, 17(1):1-12. DOI:10.1186/s13048-023-01331-x.
[33]
中华医学会围产医学分会胎儿医学学组, 中华医学会妇产科学分会产科学组. 双胎妊娠临床处理指南(2020 年更新)[J]. 中华围产医学杂志, 2020, 23(8):505-516. DOI:10.3760/cma.j.cn113903-20200812-00793.
[34]
Wang YA, Chughtai AA, Farquhar CM, et al. Increased incidence of gestational hypertension and preeclampsia after assisted reproductive technology treatment[J]. Fertil Steril, 2016, 105(4):920-926.e2. DOI:10.1016/j.fertnstert.2015.12.024.
[35]
Kim MS, Jang JH, Park S, et al. Effect of adenomyosis on adverse obstetrical outcomes in twin pregnancies achieved with assisted reproductive technology[J]. J Obstet Gynaecol, 2021, 41(8):1225-1229. DOI:10.1080/01443615.2020.1867969.
[36]
中华医学会妇产科学分会妊娠期高血压疾病学组. 妊娠期高血压疾病诊治指南(2020)[J]. 中华妇产科杂志, 2020, 55(4):227-238. DOI:10.3760/cma.j.cn112141-20200114-00039.
[37]
Li R, Zhang Q, Yang D, et al. Prevalence of polycystic ovary syndrome in women in China:a large community-based study[J]. Hum Reprod, 2013, 28(9):2562-2569. DOI:10.1093/humrep/det262.
[38]
Wu Q, Gao J, Bai D, et al. The prevalence of polycystic ovarian syndrome in Chinese women:a meta-analysis[J]. Ann Palliat Med, 2021, 10(1):74-87. DOI:10.21037/apm-20-1893.
[39]
张孝东, 邓成艳, 黄学锋, 等. 中华医学会生殖医学分会:2019年辅助生殖技术数据报告[J]. 生殖医学杂志, 2022, 31(8):1015-1021. DOI:10.3969/j.issn.1004-3845.2022.08.001.
[40]
Ashwal E, Berger H, Hiersch L, et al. Gestational diabetes and fetal growth in twin compared with singleton pregnancies[J]. Am J Obstet Gynecol, 2021, 225(4):420.e1-420.e13. DOI:10.1016/j.ajog.2021.04.225.
[41]
Fox NS, Gerber RS, Saltzman DH, et al. Glycemic control in twin pregnancies with gestational diabetes:are we improving or worsening outcomes[J]. J Matern Fetal Neonatal Med, 2015, 29(7):1041-1045. DOI:10.3109/14767058.2015.1038517.
[42]
Shemoon M, Wasana K, Ruvini N, et al. Maternal and perinatal outcomes in twin pregnancies following assisted reproduction:a systematic review and meta-analysis involving 802462 pregnancies[J]. Hum Reprod Update, 2024, 30(3):309-322. DOI:10.1093/humupd/dmae002.
[43]
Sun L, Zou G, Wei X, et al. Clinical outcomes after assisted reproductive technology in twin pregnancies:chorionicity-based comparison[J]. Sci Rep, 2016,6:1-7. DOI:10.1038/srep26869.
[44]
Seravalli V, Maoloni L, Pasquini L, et al. The impact of assisted reproductive technology on prenatally diagnosed fetal growth restriction in dichorionic twin pregnancies[J]. PLoS One, 2020, 15(4):1-10. DOI:10.1371/journal.pone.0231028.
[45]
Kondowe FJM, Clayton P, Gittins M, et al. Growth of twins conceived using assisted reproductive treatments up to 5 years old:a national growth cohort[J]. Hum Reprod, 2023, 38(4):751-761. DOI:10.1093/humrep/dead018.
[46]
赫英东, 李雨利, 陈倩. 双胎妊娠胎儿发育不均衡的妊娠结局[J]. 中华围产医学杂志, 2014, 17(02):78-81. DOI:10.3760/cma.j.issn.1007-9408.2014.02.002.
[47]
Miller J, Chauhan SP, Abuhamad AZ. Discordant twins:diagnosis, evaluation and management[J]. Am J Obstet Gynecol, 2012, 206:10-20. DOI:10.1016/j.ajog.2011.06.075.
[48]
Khalil A, Beune I, Hecher K, et al. Consensus definition and essential reporting parameters of selective fetal growth restriction in twin pregnancy:a Delphi procedure[J]. Ultrasound Obstet Gynecol, 2019, 53(1):47-54. DOI:10.1002/uog.19013.
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