Open Access Research Article

Early Multifetal Pregnancy Reduction Outcomes: Non- Chemical-Based Method Yield Improved Pregnancy Rates and Minimized Risks

Iván Madrazo1, Adrian Sánchez1, Ginna Ortiz1,2, Karla Santiago1,2, Leonardo M Porchia3, and Esther López- Bayghen3*

1Clinical Research, Instituto de Infertilidad y Genética México SC, Ingenes, México

2Maestría en Endocrinología Gineológica e Infertilidad, Ingenes/UNISON, México

3Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), México

Corresponding Author

Received Date:August 02, 2021;  Published Date: August 26, 2021


Objectives: Multifetal pregnancies increase the risk of maternal and perinatal mortality and reducing to a lower-order pregnancy attenuates this risk. We assessed a non-chemical-based procedure for multifetal pregnancy reduction.

Methods: A single-arm prospective study was conducted between December 2013 and September 2018 on patients with trichorionic triamniotic pregnancies (n=296). Multifetal pregnancy reduction was performed between gestational weeks 5 and 10. Using the same equipment for transvaginal ultrasound-guided oocyte recovery, an echo-tipped needle (17 Cook medical ovum aspiration needle) was inserted into the embryo’s cardiac area until the absence of fetal heartbeat. Afterward, the needle was extracted, and the hemostasis/vitality of the remaining embryos was verified. Patients were followed until delivery, where the birth weight was recorded as well as any complications.

Results: None of the women presented or indicated any surgical-related complications. Three patients lost their pregnancies (1.0%); however, 89.9% maintained the remaining two gestational sacs and 9.1% retained one gestational sac. The live birth rates were 95.1% for the two gestational sacs (birth weight: 2135±586 grams) and 96.3% for one gestational sac (birth weight: 2546±636 grams). The birth weight was significantly better in pregnancies that resulted in one gestational sac (p=0.001). There was a significant difference in the low birth weight rate (two sacs: 26.9% v one sac: 58.4%) but not with the very low birth weight rate (two sacs: 9.1% v one sac: 7.7%).

Conclusions: Here, we demonstrate that a non-chemical method can successfully reduce the number of embryos avoiding complications and allowing pregnancy.

Keywords: Embryo reduction; High-order multiple pregnancies; Pregnancy outcomes; Selective termination; Trichorionic triplet pregnancy

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