Pregnancy outcome after multifetal reduction via early transvaginal embryo aspiration: Mansoura fertility care unit experience

Objective: To evaluate the pregnancy outcome after multifetal pregnancy reduction (MFPR) via early transvaginal embryo aspiration.
Design: Prospective clinical study
Material and Methods: The study included 30 patients with high-order multifetal gestations (more than 3 fetuses), Pregnancies included, before reduction: 22 quadruplet gestations (group 1) and 6 quintuplets (group 2), and 2 sextuplets (group 3). All pregnancies were reduced to twins. The primary outcome measures included procedure complications while the secondary ones were pregnancy outcomes.
Results: The procedure was successfully completed in all cases. Miscarriage occurred in 2/30 patients (6.6%). Preterm delivery occurred in 20/30 cases (66.6%). The incidence of early pregnancy complications and neonatal outcomes in reduced pregnancies were similar to that of the control group. However, the cesarean section rate of reduced twin pregnancies was significantly higher (P < 0.05).
Conclusion: Early transvaginal embryo aspiration is a safe, effective and simple operation. It is associated with reduced perinatal morbidity and mortality as well as minimal maternal complication.

Keywords
High order pregnancy, multifetal embryo reduction, early transvaginal embryo aspiration.