OUTCOMES OF MULTIFETAL PREGNANCY REDUCTION IN MULTIPLE PREGNANCIES ACHIEVED BY INTRACYTOPLASMIC SPERM INJECTION USING EJACULATED, TESTICULAR, OR EPIDIDYMAL SPERM

Objective: To report the pregnancy outcome after transabdominal multif etal pregnancy reduction in multiple pregnancies achieved by intracyto plasmic sperm injection. Methods: One twin and 13 triplet pregnancies obtained by intracytoplasmic sperm injection underwent pregnancy reduc tion. Pregnancies were achieved with ejaculated sperm in 8, testicular sperm in 3, and epididymal sperm in 2 of these cases. All triplet pre gnancies were reduced to twins at 10-12 weeks' gestation by transabdom inal potassium chloride injection. A twin pregnancy with spina bifida affecting 1 fetus was reduced to singleton at 1 8 weeks of pregnancy. Results: There was no failed procedure and no pregnancy loss within th e first 4 weeks after the procedure. A complete miscarriage (7.1%) dev eloped in 1 case at 17 weeks' gestation which was due most probably to the incompetent cervix. In utero fetal death occurred in 1 fetus of a nother reduced pregnancy. Three of the reduced pregnancies delivered a t term, after 37 completed weeks, four premature deliveries occurred b etween 31 and 35 gestational weeks, and four pregnancies were ongoing beyond 25 weeks' gestation. A total of 16 fetuses, from seven twin and two singleton pregnancies, were delivered without perinatal mortality . Conclusions: Although the sample size was small, our experience indi cates that the reduction of triplets obtained by sophisticated inferti lity treatments such as intracytoplasmic sperm injection using testicu lar or epididymal sperm seems to be a safe method and can be effective ly used.