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Nutrition a major factor in rise in twin pregnancies
June 21, 2006The commonly held view that IVF is the only culprit in the steady increase in the numbers of twins born over the past thirty years was challenged by a scientist speaking at the 22nd annual conference of the European Society of Human Reproduction and Embryology in Prague, Czech Republic, Wednesday 21 June 2006. Professor Robert Jansen, Medical Director of Sydney IVF, Sydney, Australia, said that his research had shown that improved nutrition, both maternal and in the lab in the case of IVF, had produced better and stronger embryos.
"Over the last 100 years, both in the UK and Australia, there has been an increase in identical twinning through the division of the embryo into two, even without IVF", he said, "and with the move to single embryo transfer with IVF this trend is obviously set to continue." Professor Jansen went on to say that the present rate of identical twinning with IVF is between one-in-a-hundred and one-in-fifty, a little over twice the rate involved when getting pregnant naturally.
"As IVF techniques improved there was a steady and substantial increase in MZ twinning, but starting from a low base — much lower than with natural conceptions", said Professor Jansen. "Our study shows for the first time that the increase we've seen coincides with improving culture conditions and that it started before any manipulation of the zona — the 'shell' of the egg — began. Transfer of just one embryo can therefore still lead to twins. If a higher rate of MZ twinning turns out to be a natural adaptation to improved nutrition or culture conditions, it could prove difficult to reverse as embryo quality continues to improve — whether in the IVF lab or in the community generally."
"Because two implanted embryos have twice the chance of MZ twins than a single implanting embryo the best way of minimising MZ as well as DZ twinning is to transfer one embryo at a time, irrespective of the age of the mother to be", he said.
In another other presentation to the conference, Mr. Graham Scotland, from the Health Economics Research Unit, University of Aberdeen, Aberdeen, UK, described how he and his colleagues had conducted work that throws light on why some couples prefer double embryo transfer (DET), despite being aware of the risks of twin pregnancy. His team assessed patients' preferences for a range of adverse birth outcomes associated with twin pregnancies — cerebral palsy, cognitive impairments, visual impairments, perinatal death — as well as a scenario in which treatment failed and they did not become pregnant. Participants were asked to read several cards describing the treatment outcomes and then asked hypothetical questions to elicit their preference value for each.
"The results showed that many women awaiting IVF appear to prefer the prospect of a chronic adverse birth outcome rather than childlessness", said Mr. Scotland. "Having no child at all was valued significantly lower than having a child with physical, cognitive or visual impairments, but significantly higher than perinatal death. Our work suggests that couples may need to be convinced that their chances of live birth with single embryo transfer are as high as they would be with DET, before they will voluntarily accept it."
European Society for Human Reproduction and Embryology
Twin Pregnancy Current Events and Twin Pregnancy News RSSComplications early in pregnancy or in previous pregnancies adversely affect existing or subsequent pregnancies
Complications in early pregnancy or in previous pregnancies can predict the likelihood of further problems in current or subsequent pregnancies, according to research carried out by an international group of experts.
Size of a woman's uterus can predict whether she is at risk of having very premature twins after IVF
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