Transferring more than one embryo increases the risk of obstetric and perinatal complications
The aim of this study, which was conducted by the Department of Reproductive Medicine at Dexeus Mujer and led by Dr. Elisabet Clua and Dr. Eva Meler, director of R&D+i of the facility's Obstetrics Division, was to describe obstetric and perinatal complications in pregnancies achieved through assisted reproduction techniques within the framework of egg donation programmes.
To this end, the authors conducted a retrospective study of a total of 225 singleton pregnancies, 113 multiple pregnancies and 447 newborn infants in patients who had undergone treatment at the facility.
The study found a higher incidence of obstetric complications in multiple pregnancies compared to singleton pregnancies, with a higher percentage of pre-eclampsia (24.8% vs. 8%), premature rupture of membranes (9.7% vs. 1.8%) and premature births (54.9% vs. 10.2%). The indication for caesarean delivery was also more common in multiple pregnancies: 81.4% versus 64%. Maternal age is also a decisive factor, as the indication for caesarean delivery in women carrying only one child was higher among those over the age of 40 years: 73.5% vs. 49.4%.
As regards perinatal problems, the incidence of complications such as low birth weight (less than 2,500 g) or need for intensive care was also higher in infants born as a result of multiple pregnancies: 61.1% vs. 8.2% for low birth weight, and 15.2% vs. 4.7% for admissions to intensive care. Also, while perinatal mortality was 13.5‰ among babies born after multiple pregnancies, not a single such case was recorded among the singleton pregnancies analysed in the study.
Considering these findings, the authors underscore the need for preconception counselling for parents and women undergoing assisted reproduction techniques in the context of egg donation programmes in order to inform them of the complications and of the advantage that transferring a single embryo per cycle may represent to avoid possible obstetric and perinatal risks.
The results of this study were published in the journal of Gynecological Endocrinology.
Obstetric and perinatal complications in an oocyte donation programme. Is it time to limit the number of embryos to transfer?
Clua E, Meler E, Rodríguez D, Coroleu B, Rodríguez I, Martínez F, Tur R.
Gynecol Endocrinol. 2016 Apr;32(4):267-71. doi: 10.3109/09513590.2015.1111330