1. 何積泓 2008-09-02

2. Infertility The incidence of infertility is increasing The incidence of infertility is increasing 1.3~4.2% newborns in Europe result from ART 1.3~4.2% newborns in Europe result from ART Multiple pregnancy rate after ART: 26.4% Multiple pregnancy rate after ART: 26.4% No difference in perinatal outcome of twin pregnancies No difference in perinatal outcome of twin pregnancies

3. Vanishing twin syndrome A first-trimester missed abortion of one of the twins A first-trimester missed abortion of one of the twins After ART, singletons originating from a twin gestation: 10.4~12.2% After ART, singletons originating from a twin gestation: 10.4~12.2% 36% of twin pregnancies have missed abortion 36% of twin pregnancies have missed abortion Controversial perinatal outcome Controversial perinatal outcome

4. Materials and Methods January 1999 to December 2005 January 1999 to December 2005 All singletons after IVF/ICSI (794) All singletons after IVF/ICSI (794) Fetal reduction excluded Fetal reduction excluded Study group (n=46): singletons from a twin gestation Study group (n=46): singletons from a twin gestation Matched control group (n=92): singletons from a single gestation Matched control group (n=92): singletons from a single gestation

5. Results

6. Result

7. Result Admission to a neonatal care unit: 5 (10.9%) versus 7 (7.6%) Admission to a neonatal care unit: 5 (10.9%) versus 7 (7.6%) Mean duration of hospitalization: 38.3 versus 14.6 days Mean duration of hospitalization: 38.3 versus 14.6 days No maternal or neonatal death during hospitalization No maternal or neonatal death during hospitalization

8. Discussion 6% singleton deliveries after IVF/ICSI originated from vanish twin 6% singleton deliveries after IVF/ICSI originated from vanish twin Higher frequency of low birth weight and SGA Higher frequency of low birth weight and SGA Chromosome aberration ? Chromosome aberration ? Infection ? Infection ? Potential blood shunting through inter-twin vascular anastomoses Potential blood shunting through inter-twin vascular anastomoses

9. Thanks for your attention!