Analysis of Clinical Outcomes of Transvaginal Ultrasound-guided Multifetal Pregnancy Reduction in 67 Cases after Assisted Reproduction

Objective To evaluate the clinical outcomes and assess the safety of transvaginal ultrasound-guided multifetal pregnancy reduction(MPR) in the first trimester after assisted reproduction.Methods A total of 67 cases of multiple gestation were collected after in vitro fertilization and embryo transfer(IVF-ET),intra-cytoplasmic sperm injection(ICSI),pre-implantation genetic diagnosis(PGD),and intrauterine insemination(IUI).They received transvaginal ultrasound-guided fetal reduction during 7 ～ 11 weeks in our center from January 2004 to January 2009.The pregnancy outcomes after MPR including the rate of vaginal bleeding,abortion,premature deliveries,and low weight babies were analyzed.Results There were ten(14.9%) patients complained with vaginal bleeding and one(1.5%) patient complained abdominal pain after MPR.Among 67 cases,46 women have delivered 65 babies.The total pregnancy loss rate was 9.0%(6/46).23.9%(11/46) of pregnancies delivered before 37 weeks gestation,including 6.5% delivered before 32 weeks.In 65 infants,The mean birth weight was 2 688 ± 651(1 350 ～ 4 250) g and 35.4 %(23/65) babies were low weight( 2 500 g).The percentage of very low birth weight infants was 6.2%( 1 500 g).The premature deliveries rate of pregnancies and the percentage of low weight infants reduced to singleton was significantly lower than those in reduced to twins(P=0.007 and P0.001).And the embryos number before MPR also significantly impacted the pregnancy outcomes.Compared to twin group without reduction,the pregnancy outcomes were better in the single group.Conclusion MPR seemed to be a relatively safe and efficient method to improve the outcomes of multiple pregnancy after assisted reproduction.