Monozygotic twinning after assisted reproductive techniques: A phenomenon independent of micromanipulation

M. Schachter, A. Raziel, S. Friedler, D. Strassburger, O. Bern, R. Ron-El

Research output: Contribution to journalArticlepeer-review

205 Scopus citations


A 3 year retrospective analysis was conducted of pregnancies achieved after various assisted reproductive treatment modalities in our infertility practice, to calculate and compare the rates of monozygotic twinning (MZT). A total of 731 pregnancies achieved after various assisted reproduction treatments were reviewed. Gonadotrophin therapy for induction of ovulation and controlled ovarian hyperstimulation (COH) yielded 129 clinical pregnancies. Conventional IVF yielded 139 pregnancies. IVF and intracytoplasmic sperm injection (ICSI) with or without assisted hatching (AH) yielded 463 pregnancies, all during the same time period. The rates of multiple pregnancy (monozygotic and dizygotic) twins and triplets were recorded. MZT was found in 1.5% of ovulation induction or COH pregnancies (2/129). The incidence of MZT after conventional IVF was 0.72% (1/139). After IVF-ICSI/AH, MZT was found in 0.86% (4/463). The overall rate of MZT was 0.95% (7/731). Five cases were dizygotic triplets and two cases were monozygotic twins. We found the rate of MZT after assisted reproduction treatment increased more than two-fold over the background rate in the general population. Dizygotic triplets were found more often than monozygotic twins. The rate of MZT was consistently increased, irrespective of treatment modality or micromanipulation. This may signify that the aetiology of increased MZT after assisted reproduction is the gonadotrophin treatment rather than in-vitro conditions, micromanipulation, or multiple embryo transfer.

Original languageEnglish
Pages (from-to)1264-1269
Number of pages6
JournalHuman Reproduction
Issue number6
StatePublished - 1 Jan 2001
Externally publishedYes


  • Gonadotrophin therapy
  • Micromanipulation
  • Monozygotic twins
  • Multiple pregnancy
  • Zona pellucida

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology


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