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Assisted Reproductive Technology and Twin Pregnancy
Research Guide
What is Assisted Reproductive Technology and Twin Pregnancy?
Assisted Reproductive Technology and Twin Pregnancy refers to the use of fertility treatments like in vitro fertilization that increase the incidence of twin gestations and their associated perinatal risks including birth defects, imprinting disorders, and neurological outcomes.
The field encompasses 130,383 works examining how assisted reproductive technology, particularly in vitro fertilization, affects perinatal outcomes in twin pregnancies. Palermo (1992) reported pregnancies after intracytoplasmic injection of a single spermatozoon into an oocyte, highlighting early ART techniques linked to multiple gestations. Twin pregnancies from ART carry specific risks such as twin-to-twin transfusion syndrome in monochorionic twins, managed through interventions like fetoscopic laser coagulation and selective embryo transfer.
Topic Hierarchy
Research Sub-Topics
Perinatal Outcomes in IVF Pregnancies
This sub-topic analyzes risks like preterm birth, low birth weight, and maternal complications in pregnancies from in vitro fertilization. Researchers compare IVF outcomes to spontaneous conceptions using large cohort studies.
Twin Pregnancy Management
This sub-topic covers prenatal surveillance, delivery timing, and complications specific to dizygotic and monozygotic twins. Researchers study ultrasound monitoring, cerclage, and mode of delivery strategies.
Birth Defects in Assisted Reproductive Technology
This sub-topic investigates congenital anomalies, including cardiac and neural tube defects, associated with ART procedures. Researchers explore epigenetic risks and long-term surveillance data.
Fetoscopic Laser Coagulation for Twin-to-Twin Transfusion Syndrome
This sub-topic focuses on surgical techniques for treating TTTS in monochorionic twins, including outcomes and complications. Researchers evaluate survival rates and neurodevelopmental follow-up.
Neurodevelopmental Outcomes in ART Children
This sub-topic examines long-term cognitive, motor, and behavioral outcomes in children conceived via ART, including imprinting disorder risks. Researchers use cohort studies to assess potential epigenetic effects.
Why It Matters
Assisted reproductive technology contributes to higher rates of twin pregnancies, which elevate risks of adverse perinatal outcomes including hypertensive disorders and twin-to-twin transfusion syndrome, as noted in recent studies on monozygotic and dichorionic twins. For instance, "Twin pregnancies are risk factors for both early- and late-onset hypertensive disorders of pregnancy: the Japan Environment and Children’s study" identifies ART and advanced maternal age as key risk factors, with shared placentas increasing complications. "Parental mixed-gender preferences revealed by IVF twin births" shows IVF raises dizygotic twin proportions through multiple embryo transfers, impacting global fertility patterns. Three-person IVF has produced eight healthy children, preventing mitochondrial DNA disease transmission, as reported in news coverage from 2025. These applications affect obstetrics, pediatrics, and public health by necessitating optimized embryo transfer strategies to reduce multiples.
Reading Guide
Where to Start
"BIRTH AFTER THE REIMPLANTATION OF A HUMAN EMBRYO" by P. C. Steptoe, Robert Edwards (1978) provides the foundational human IVF success, essential for understanding ART origins and twin pregnancy risks.
Key Papers Explained
"BIRTH AFTER THE REIMPLANTATION OF A HUMAN EMBRYO" (Steptoe and Edwards, 1978) established IVF births, extended by Palermo (1992) in "Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte" for ICSI techniques increasing multiples. Neale and Cardon (1992) in "Methodology for Genetic Studies of Twins and Families" builds analytical frameworks for twin data from ART. Boivin et al. (2007) quantify infertility prevalence driving ART demand, while Mascarenhas et al. (2012) track global trends informing twin risk epidemiology.
Paper Timeline
Most-cited paper highlighted in red. Papers ordered chronologically.
Advanced Directions
Recent preprints like "Assisted reproductive technology and reproductive, perinatal, and maternal outcomes: evidence from an umbrella review of systematic reviews with meta-analyses of randomized controlled trials" (2025) evaluate ART evidence strength. "Twin pregnancies are risk factors for both early- and late-onset hypertensive disorders of pregnancy: the Japan Environment and Children’s study" (2026) examines ART twin risks. News on AI-assisted IVF and three-person IVF births signal ongoing clinical frontiers.
Papers at a Glance
| # | Paper | Year | Venue | Citations | Open Access |
|---|---|---|---|---|---|
| 1 | Nelson Textbook of Pediatrics | 1976 | The Medical Journal of... | 5.3K | ✕ |
| 2 | Methodology for Genetic Studies of Twins and Families | 1992 | — | 4.1K | ✕ |
| 3 | Pregnancies after intracytoplasmic injection of single spermat... | 1992 | The Lancet | 3.5K | ✕ |
| 4 | BIRTH AFTER THE REIMPLANTATION OF A HUMAN EMBRYO | 1978 | The Lancet | 2.6K | ✕ |
| 5 | Effective targeted gene ‘knockdown’ in zebrafish | 2000 | Nature Genetics | 2.5K | ✕ |
| 6 | International estimates of infertility prevalence and treatmen... | 2007 | Human Reproduction | 2.4K | ✓ |
| 7 | The Developing Human: Clinically Oriented Embryology | 1973 | — | 2.3K | ✕ |
| 8 | National, Regional, and Global Trends in Infertility Prevalenc... | 2012 | PLoS Medicine | 2.2K | ✓ |
| 9 | Clinical gynecologic endocrinology and infertility | 1983 | — | 2.1K | ✕ |
| 10 | The Increasing Trend in Caesarean Section Rates: Global, Regio... | 2016 | PLoS ONE | 2.1K | ✓ |
In the News
Parental mixed-gender preferences revealed by IVF twin births
In vitro fertilization (IVF) affects human fertility by 1) increasing the probability of multiple births through the transfer of multiple embryos, 2) raising the proportion of dizygotic twins, whic...
The first AI-assisted IVF babies are now being born
labs. Clinics can join the Society for Assisted Reproductive Technology (SART), which publishes success rates and ensures that member clinics are adhering to ethical guidelines, but membership is o...
‘Landmark’ study: three-person IVF leads to eight healthy children
Long-awaited results suggest that mitochondrial donation can prevent babies from inheriting diseases caused by mutant mitochondria. By * Ewen Callaway 1. Ewen Callaway View author publications
Three-person IVF technique spared children from inherited diseases, scientists say
In 2015, the UK became the first country in the world to legalize research into mitochondrial donation treatment in humans.
Eight babies born after mitochondrial donation treatment to reduce transmission of mitochondrial DNA disease
### Funding
Code & Tools
This is the repository providing the code and the data associated with the paper " **Mothers with higher twinning propensity had lower fertility in...
## Repository files navigation # X-factor-ART This repository contains all the scripts, data, figures, and visualizations that support the text i...
This repository contains software for the MR-Twin paper ("Leveraging family data to design Mendelian Randomization that is provably robust to popul...
## Repository files navigation # Whole genome risk prediction of common disease in human pre-implantation embryos
This repository contains R code used to calculate the possible gain in phenotype value achievable in embryo selection experiments under Gaussian mo...
Recent Preprints
Vanishing Twin Syndrome - StatPearls - NCBI Bookshelf
- Use of assisted reproductive techniques (ART) such as; in vitro fertilization (IVF) [\[5\]] - Increase the incidence of multiple gestations - Small placenta or other anatomical abnormalities o...
Commercial Impacts on Assisted Reproductive Technology
Assisted reproductive technologies (ART) encompass all interventions where both human eggs and sperm or embryos are handled in the laboratory for the purposes of achieving a pregnancy. This include...
Assisted reproductive technology and reproductive, perinatal, and maternal outcomes: evidence from an umbrella review of systematic reviews with meta-analyses of randomized controlled trials
The expanding global use of assisted reproductive technology (ART) warrants rigorous evidence synthesis. This umbrella review (UR) evaluated the strength and validity of evidence on ART effects on ...
Twin pregnancies are risk factors for both early- and late-onset hypertensive disorders of pregnancy: the Japan Environment and Children’s study
10 \]. Additionally, because they share a common placenta, MD- and MM-twin pregnancies have specific risks of complications, such as twin-to-twin transfusion syndrome, which contributes to adverse ...
Differences in Maternal and Neonatal Outcomes Between ...
Pregnancies following Assisted Reproductive Technology (ART) are associated with increased risk for adverse maternal and neonatal outcomes. However, it is not clear if these associations are derive...
Latest Developments
Recent developments in assisted reproductive technology (ART) and twin pregnancy research as of February 2026 include the integration of artificial intelligence (AI) for embryo selection and cycle management, which enhances success rates and personalization of treatments (Progenesis IVF, WMedTour). Additionally, research suggests that blastocyst development may serve as a surrogate marker for pregnancy success, and policies now mandate coverage for IVF and infertility treatments in certain regions like California (ASRM, California Senate). Studies also indicate that twin pregnancies following assisted reproduction are a significant focus, with ongoing research into maternal and perinatal outcomes (PubMed, SGUL).
Sources
Frequently Asked Questions
What is the role of in vitro fertilization in twin pregnancies?
In vitro fertilization increases twin pregnancy incidence through multiple embryo transfers, raising dizygotic twin rates. "Parental mixed-gender preferences revealed by IVF twin births" notes this effect on human fertility. Selective embryo transfer mitigates these risks.
How does assisted reproductive technology affect perinatal outcomes?
ART links to higher risks of birth defects, imprinting disorders, and neurological sequelae in twins. Recent preprints confirm associations with adverse maternal and neonatal outcomes beyond infertility itself. Umbrella reviews synthesize evidence from randomized trials on these effects.
What are key risks in ART-induced twin pregnancies?
Risks include vanishing twin syndrome, more common with IVF, and twin-to-twin transfusion syndrome in monochorionic twins. Small placentas or genetic factors contribute to early losses. Fetoscopic laser coagulation manages severe cases.
What historical milestones define ART?
Steptoe and Edwards (1978) achieved the first birth after human embryo reimplantation. Palermo (1992) demonstrated pregnancies via intracytoplasmic sperm injection. These advanced IVF techniques central to twin pregnancy studies.
What is the current state of three-person IVF?
Three-person IVF via mitochondrial donation has led to eight healthy children, sparing them inherited mitochondrial diseases. UK legalized this in 2015, with 2025 reports confirming success. It represents progress in preventing genetic disorders in ART.
Open Research Questions
- ? How do maternal and neonatal outcomes differ between ART pregnancies and natural conceptions when accounting for underlying infertility?
- ? What are the long-term neurodevelopmental effects of vanishing twin syndrome in ART twin gestations?
- ? Can selective embryo transfer fully mitigate hypertensive disorder risks in ART twin pregnancies?
- ? What genetic factors beyond ART contribute to monozygotic twinning and associated imprinting disorders?
- ? How does population stratification affect Mendelian randomization studies of twin outcomes in ART?
Recent Trends
ART use expands globally, with umbrella reviews in 2025 synthesizing perinatal outcomes from RCTs.
Preprints highlight twin pregnancies as risk factors for hypertensive disorders, linking ART to complications like vanishing twin syndrome.
News reports first AI-assisted IVF babies and eight healthy children from three-person IVF in 2025, alongside rising caesarean rates tied to multiples in Betrán et al. .
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