Is vanishing twin syndrome associated with adverse obstetric outcomes of ART singletons? A systematic review and meta-an
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ASSISTED REPRODUCTION TECHNOLOGIES
Is vanishing twin syndrome associated with adverse obstetric outcomes of ART singletons? A systematic review and meta-analysis Yi-xin Li 1,2,3 & Tian-ze Sun 2,3,4 & Mo-qi Lv 1,2,3 & Liang Zhou 5 & Pan Ge 1,2,3 & Hao-nan Li 2,3,6 & Dang-xia Zhou 1,2,3 Received: 14 May 2020 / Accepted: 17 August 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose The objective of our meta-analysis was to estimate the effect of VTS on obstetric outcomes of ART singletons. Methods PubMed, Embase, MEDLINE, and ClinicalTrials.gov were searched up to January 2019 to find studies reporting the obstetric outcomes of ART singletons with VTS. Dichotomous data were expressed as odds ratios (OR) with 95% confidence intervals (CI). Continuous data were expressed as weighted mean difference (WMD) with 95% CI. Results A total of 17 observational studies encompassing more than 60,000 ART singletons were included in this meta-analysis. The impact of VTS on singletons was highly dependent on the definition of VTS, precisely, the vanishing timing and intrauterine growth stage. When VTS happened at or before 14 weeks, regardless of intrauterine growth stage, there were no differences in terms of gestational age (GA) [WMD = − 0.08, 95% CI = − 0.27, 0.10], preterm birth (< 37 weeks) (PTB) [OR = 1.23, 95% CI = 0.89, 1.70], and low birth weight (< 2.5 kg) (LBW) [OR = 1.56, 95% CI = 1.00, 2.43] in original singletons versus singleton with VTS. On the contrary, VTS occurred after 14 weeks was associated with significantly shorter GW and lower BW, as well as higher risks of PTB and LBW. When the sac reduced in VTS was an empty gestational sac, there would be no differences in GW, PTB, and LBW between singletons versus singletons with VTS, whereas the loss of a fetus with cardiac-activity was associated with adverse obstetric outcomes. Conclusions This meta-analysis suggests whether or not VTS is harmful to obstetric outcomes is highly dependent on the vanishing timing and intrauterine growth stage. Keywords Vanishing twin syndrome . VTS . Assisted reproductive technique . Obstetric outcome
Yi-xin Li and Tian-ze Sun contributed equally to this work. * Dang-xia Zhou [email protected] 1
Department of Pathology, Medical School, Xi’an Jiaotong University, Xi’an 710061, China
2
Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an 710061, China
3
Institute of Genetics and Developmental Biology, Xi’an 710061, China
4
Department of Human Anatomy and Histology and Embryology, Medical School, Xi’an Jiaotong University, Xi’an 710061, China
5
Reproductive Medicine Center, North-West Maternal and Child Hospital, Xi’an 710003, China
6
Department of Pathogenic Biology and Immunology, Medical School, Xi’an Jiaotong University, Xi’an 710061, China
Introduction Over the past three decades, assisted reproductive technologies (ART) have resulted in many thousands of successful pregnancies each year. With the advanced achievements in ART treatments, the ob
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