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A comparative study of singleton pregnancies after an IVF procedure revealed no significant differences in the course or outcome of pregnancy. On the other hand, multiple pregnancy itself is a risk factor for the course and outcome of pregnancy and birth. Since it is approximately twenty times more frequent in medically assisted than in natural conception and therefore constitutes one of the major problems of IVF pregnancy and birth. The aim of our research was to determine whether the course and obstetric outcome of twin IVF pregnancy differs from those in natural conception. This retrospective study included 731 women with twin pregnancies who gave birth to twins between April 1987 and May 1995. We studied 94 twin pregnancy mothers and 188 newborns conceived by an IVF procedure. The research project was divided into a cohort and control study. In the former, the study group was compared to the entire Ljubljana cohort of 637 mothers with twin pregnancy and 1274 newborns born after natural conception. In the control study, we compared the study group to 93 twin pregnancy mothers and 186 newborns born after natural conception. Women in the study group and control group were matched for age, parity and birth year. The course and complications of pregnancy, the course, complications and outcome of birth, and the characteristics of newborns were analysed. The incidence of severe complications of pregnancy, such as hypertension, eclampsy, polysymptomatic gestosis, gestation
diabetes and threatened pre-term labour, in the IVF group of mothers with twin pregnancy did not exceed that in the control group. The former had, however, a higher rate of bleeding episodes in the first trimester, and less proteinuria compared to the control group. In addition, the IFV group showed a lower average gestation age, more premature labours, more elective and urgent caesarean sections and a lower average birth weight than the control group. Women with twin pregnancy as a result of IVF run no greater obstetric risk than pregnant women after natural conception. Their children may be born somewhat earlier and may have lower birth weight, yet the perinatal outcome of these newborns does not differ from that of children born after natural conception.