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Recording available 2/16-5/2
Recording available 2/16-5/2
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Abstract Award
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Poster Session 1

Category: Prematurity

Poster Session 1

(314) Twin pregnancy following assisted reproductive treatments: Is it a risk factor for adverse perinatal outcome?

Wednesday, February 11, 2026
10:30 AM - 12:00 PM  

    Submitting Author and Presenting Author(s)

  • Noa Leybovitz Haleluya, MD (she/her/hers)

    OB/Gyn resident
    Soroka Medical Center
    meitar, HaDarom, Israel

    • Coauthor(s)

  • Tamar Wainstock, PhD (she/her/hers)

    Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev
    Beer Sheva, HaDarom, Israel

  • Eyal Sheiner, MD, PhD

    Deichmann Lerner Full Professor of Obstetrics & Gynecology; Chairman of the Division of OBY&GYN
    Soroka University Medical Center, Faculty of Health Sciences, Ben‑Gurion University of the Negev
    beer sheva, HaDarom, Israel

Objective:
Assisted reproductive techniques (ART), including in vitro fertilization (IVF) and ovulation induction (OI), have become increasingly widespread. While it is well established that singleton pregnancies conceived via ART carry a higher risk for adverse outcomes compared to spontaneously conceived singletons, the evidence regarding twin pregnancies is less consistent. Specifically, it remains unclear whether the increased risks associated with ART persist in multiple gestations. This study aimed to evaluate whether twin pregnancies conceived via ART are independently associated with increased rates of perinatal complications

Study Design:

A population-based cohort study including all offspring of twin gestations, born between the years 1991-2021 at a tertiary medical center was conducted. Perinatal morbidity and mortality, as well as obstetrical complications were assessed among twin pregnancies conceived by IVF, OI or spontaneously. Infants with congenital malformations were excluded. A multivariable generalized estimating equation (GEE) model was used to adjust for confounders. 

Results:

The study included 7790 newborns: 1380 (17.7%) were conceived by IVF, 696 (8.9%) by OI and 5714 (73.3%) with no ART. Twins pregnancies conceived by ART were at an increased risk for adverse perinatal outcome (Table): The rates of preterm delivery< 37 weeks and preterm delivery< 34 weeks were significantly higher in ART groups. In addition, significantly higher rates of low birthweight as well as very low birthweight were noted in ART groups. Higher rates of cesarean delivery were also noted in the ART groups. Using a multivariable GEE model, IVF remained an independent risk factor for preterm delivery< 37 weeks (adjusted OR 1.57, 95% CI 1.30-1.89; p< 0.001) as well as for cesarean deliveries (adjusted OR 2.05, 95% CI 1.64-2.56; p< 0.001). No independent association was found between OI and adverse perinatal outcomes while controlling for potential confounders.

Conclusion:

Twin pregnancies conceived via IVF are independently associated with an increased risk of preterm delivery (< 37 weeks) and cesarean delivery.