July 5, 2011
Taller Women More Likely To Have Twins After Double Embryo Transfer
Finding could help develop personalized fertility treatment
The researchers say that this is the first time the effect of maternal height on multiple implantation has been shown. "In natural dizygotic twinning it is not possible to distinguish between multiple ovulation and implantation," said Dr. Lambers "whereas by studying pregnancies in mothers who have undergone DET we know exactly how many embryos were transferred and can therefore draw firm conclusions about the factors that influence the development of twin pregnancies."
Of the 6589 patients who completed their first IVF cycle, 2357 women had DET, resulting in 371 singleton and 125 twin pregnancies. "When we came to analyse the twin group, we found that a maternal height of over 1.74cm and more than 11 oocytes retrieved were independently associated with twin pregnancies," said Dr. Lambers.
"The positive relationship between a higher number of oocytes retrieved and a twin pregnancy probably reflects the fact that these women would have had a larger choice of good quality embryos. But the association between increased height and multiple pregnancy is more difficult to explain. Previous studies have shown that women who are prone to conceive twins after IVF have a higher level of vascular endothelial growth factor-A (VEGF-A), which promotes the growth of blood vessels at the site of implantation. Perhaps there is also an association between tall stature and increased VEGF-A levels," she said.
"Doctors working in IVF are faced with a constant balancing act between giving the best chance of achieving a pregnancy without incurring all the problems associated with multiple births," said Dr. Lambers. "We hope that our work could be used in future as a basis for predictive models that assist in the choice between single and double embryo transfer. This is an important topic, since multiple pregnancies involve a higher risk of problems for the mother, such as pre-eclampsia, and also for the baby due to pre-term or immature delivery."
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