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. 2026 Jan 31:S0015-0282(26)00047-6.
doi: 10.1016/j.fertnstert.2026.01.018. Online ahead of print.

Differences in congenital anomalies in unassisted conception vs. in vitro fertilization in dichorionic-diamniotic twin pregnancies

Hannah S Foster  1 , Meaghan G McCabe  2 , Nathaniel Koelper  2 , Bryann Bromely  3 , Stephen Chasen  4 , Melissa L Russo  5 , Ashely S Roman  6 , Meghana A Limaye  6 , Angela C Ranzini  7 , Caitlin Clifford  8 , Joseph R Biggio Jr  9 , Akela Subramaniam  10 , Avinash S Patil  11 , Samantha Wedd  12 , Jessica M Page  13 , Sara Nicholas  14 , Jay Idler  15 , Rashmi Rao  16 , Amber Crowder  17 , Raj Shree  18 , Graham McLennan  19 , Lorraine Dugoff  2
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Free article

Differences in congenital anomalies in unassisted conception vs. in vitro fertilization in dichorionic-diamniotic twin pregnancies

Hannah S Foster et al. Fertil Steril. .
Free article

Abstract

Objective: The aim of this study was to evaluate the incidence of congenital anomalies in dichorionic-diamniotic twins conceived with in vitro fertilization (IVF) vs. unassisted conception pregnancies in a large geographically diverse population.

Design: This is a secondary analysis of data from a retrospective cohort study of twin pregnancies seen at 17 centers between December, 2011-February, 2020.

Subjects: This study included dichorionic-diamniotic twins conceived unassisted, or by in vitro fertilization.

Exposure: The exposure group is dichorionic-diamniotic twins conceived with IVF.

Main outcome measure: The primary outcome was presence of a congenital anomaly. Neonates with an abnormal newborn examination were evaluated for having a major or minor congenital anomaly and the major anomalies were further classified by organ system (cardiac, renal/genitourinary, gastrointestinal, and musculoskeletal).

Results: Of the 968 dichorionic-diamniotic twin pregnancies included, 521 (53.8%) were conceived with IVF and 447 (46.2%) were conceived unassisted. Congenital anomalies were found in 70 pregnancies (7.23%). Of those, 37 were found in pregnancies conceived by IVF (52.9%) vs. 33 unassisted conception pregnancies (47.1). There were no significant differences between IVF and unassisted conception pregnancies for major anomalies or minor anomalies.

Conclusion: In this large cohort of twin pregnancies, there is no significant difference in the incidence of anomalies for dichorionic-diamniotic twin pregnancies conceived by IVF vs. unassisted conception pregnancies.

Keywords: IVF; chorionicity; congenital anomalies; dichorionic-diamniotic; pregnancy; twins.

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Conflict of interest statement

Declaration of Interests H.S.F. has nothing to disclose. M.G.M. has nothing to disclose. N.K. has nothing to disclose. B.B. reports royalties from Up-to-Date; honoraria from World Class CME and East Virginia Medical School; Board: Foundation for SMFM; Board: GoHo Foundation; Board: American Institute of Ultrasound in Medicine. S.C. has nothing to disclose. M.L.R. has nothing to disclose. A.S.R. reports funding from LabCorp for the submitted work; funding from Natera outside the submitted work. M.A.L. has nothing to disclose. A.C.R. has nothing to disclose. C.C. has nothing to disclose. J.R.B. Jr. has nothing to disclose. A.S. is on the ABMGG Board of Directors. A.S.P. has nothing to disclose. S.W. has nothing to disclose. J.M.P. has nothing to disclose. S.N. has nothing to disclose. J.I. has nothing to disclose. R.R. has nothing to disclose. A.C. has nothing to disclose. R.S. has nothing to disclose. G.L. is an employee of LapCorp. L.D. reports funding from LabCorp for the submitted work.

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