PERINATAL OUTCOME OF TRIPLET PREGNANCIES FOLLOWING ASSISTED REPRODUCTION

Purpose: This collaborative work was undertaken to assess perinatal ou tcome of in vivo conceived triplets to those following in vitro fertil ization and assisted reproductive technologies (ART). Methods: 151 tri plets were examined; 56 delivered-following ART, 55 following ovulatio n induction by gonadotropins (GN), 27 following clomiphene citrate (CC ), and 13 conceived spontaneously. Results: Mean gestational length of triplets following ART (33.2 wks) was not different from those concei ved following GN (33.4 wks) or CC (34.2 wks), but was significantly sh orter compared to triplets following spontaneous conception (35.3 wks) , Mean fetal birthweight following ART (1743 g) did not differ signifi cantly from that following GN (1683 g) or CC (1863 g) bur was signific antly lower compared to those delivered after spontaneous conception ( 1963 g). Although no difference was found in the incidence of low birt hweight infants between the groups studied, the incidence of very low birthweight newborns (<1500 g) following ART or GN was significantly h igher than following spontaneous conceptions (30.6%, 30.3% vs 10.3%). Differences in perinatal mortality were not significantly different be tween the groups examined (77.9, 60.6, 111.0, 25.6/1000 for ART, GN, C C, and spontaneous conceptions respectively). Conclusion: In conclusio n, a similar perinatal outcome was shown for triplets conceived follow ing ART and those following ovulation induction by GN, suggesting that the in vitro conditions as such were not the main contributing factor influencing the clinical outcome but rather the GN treatment. Triplet s conceived spontaneously have a better outcome compared to those foll owing ovulation induction or ART in terms of gestational length and bi rthweight.