alexa Incidence, Sex Ratio and Perinatal Outcomes of IVF and ICSI Monozygotic Twin Pregnancies Following either Cleavage or Blastocyst Stage Embryo Transfer
ISSN: 2161-0436

Human Genetics & Embryology
Open Access

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Research Article

Incidence, Sex Ratio and Perinatal Outcomes of IVF and ICSI Monozygotic Twin Pregnancies Following either Cleavage or Blastocyst Stage Embryo Transfer

Al Dibouni Z1, Shah T2, Wheat S2, Griffin DK1* and Thornhill AR1,2,3

1School of Biosciences, University of Kent, Canterbury, Kent, CT2 7NJ, UK

2The London Bridge Fertility Gynaecology and Genetics Centre, SE1 9RY, London, UK

3Illumina Inc. Illumina, Cambridge Ltd, CPC4, Capital Park, Fulbourn, Cambridge, CB21 5XE, UK

*Corresponding Author:
Griffin DK
School of Biosciences, University of Kent
Canterbury, Kent, CT2 7NJ, UK
Tel: 0044 01227 823022
E-mail: [email protected]

Received Date: October 20, 2015; Accepted Date: January 27, 2016; Published Date: February 03, 2016

Citation: Al Dibouni Z, Shah T, Wheat S, Griffin DK, Thornhill AR (2016) Incidence, Sex Ratio and Perinatal Outcomes of IVF and ICSI Monozygotic Twin Pregnancies Following either Cleavage or Blastocyst Stage Embryo Transfer. Human Genet Embryol 6:132. doi:10.4172/2161-0436.1000132

Copyright: © 2016 Al Dibouni Z, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



To determine if prolonged time in embryo culture has an effect on the rate, sex ratio, and perinatal outcomes of monozygotic twins (MZT) following either cleavage stage or blastocyst embryo transfer after assisted conception. This is a retrospective study of 2,316 consecutive clinical pregnancies resulting from cleavage stage transfer (CT) and blastocyst transfer (BT). Criteria examined included (i) incidences (ii) sex ratios (iii) gestational age and birth weight; (iv) perinatal outcomes of these pregnancies from cleavage stage and blastocyst transfer procedures. Monozygotic twin pregnancies were identified by (i) presence of a gestational sac containing more than one fetal pole with cardiac activity, (ii) the number of gestational sacs or fetal hearts exceeds the number of embryos transferred and (iii) twin pregnancies following a single embryo transfer. Overall the incidence of twinning was 1.64% (38 out of 2,316 pregnancies). The frequency of twinning was 2.3 × higher following BT (18 out of 649) compared to CT (20 out of 1,667). IVF techniques skewed the sex ratio in favour of males while ICSI significantly favoured females. There was no statistically significant difference between transfer type and gestational age, birth weight and perinatal outcome. All pregnancies resulted in the birth of 86 infants. In our experience, BT more than doubles the chances of conceiving a monozygotic twin pregnancy, however IVF techniques lead to a greater likelihood of male birth(s) if twins are conceived. Appropriate pre-conception counselling should be given to advise the potential risks associated with both types of transfer as well as using alternative methods such as single embryo transfer to reduce the risk of multiple gestations.


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