{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T07:46:48Z","timestamp":1740124008413,"version":"3.37.3"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T00:00:00Z","timestamp":1625788800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T00:00:00Z","timestamp":1625788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003407","name":"Ministero dell\u2019Istruzione, dell\u2019Universit\u00e0 e della Ricerca","doi-asserted-by":"publisher","award":["2017728JPK"],"award-info":[{"award-number":["2017728JPK"]}],"id":[{"id":"10.13039\/501100003407","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Assist Reprod Genet"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>The risk of monozygotic (MZT) twinning is increased in pregnancies after assisted reproductive technologies (ART). However, determinants remain poorly understood. To shed more light on this issue, we analyzed the estimated frequency of MZT twins from ART in Lombardy, Northern Italy, during the period 2007\u20132017.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This is a population-based study using regional healthcare databases of Lombardy Region. After having detected the total number of deliveries of sex-concordant and sex-discordant twins from ART, we calculated MZT rate using Weinberg\u2019s method. Standardized ratios (SRs) and corresponding 95% confidence intervals (CI) of MZT deliveries, adjusted for maternal age, were computed according to calendar period, parity, and type of ART.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>On the whole, 19,130 deliveries from ART were identified, of which 3,446 were twins. The estimated rate of MZT births among ART pregnancies was higher but decreased over time (p-value = 0.03); the SRs being 1.33 (95% CI: 1.18\u20131.51), 0.96 (95% CI: 0.83\u20131.11), and 0.92 (95% CI: 0.79\u20131.07) for the periods 2007\u20132010, 2011\u20132014, and 2015\u20132017, respectively. The SRs of MZT among women undergoing first-level techniques, conventional in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI) were 0.47 (95% CI: 0.38\u20130.57), 1.02 (95% CI: 0.88\u20131.17), and 1.43 (95% CI: 1.27\u20131.61) (p-value &lt; 0.0001). The ratio of MZT births was significantly higher in women younger than 35 years (p-value &lt; 0.0001) and slightly higher among nulliparae (p-value &lt; 0.0001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Despite a reduction of MZT rate from ART over the time, the risk remains higher among ART pregnancies rather than natural ones. Younger women and women undergoing ICSI showed the highest risk of all.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10815-021-02268-0","type":"journal-article","created":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T19:03:46Z","timestamp":1625857426000},"page":"2341-2347","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Trend of medically induced monozygotic twin deliveries according to age, parity, and type of assisted reproductive technique during the period 2007\u20132017 in Lombardy Region, Northern Italy: a population-based study"],"prefix":"10.1007","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7894-4456","authenticated-orcid":false,"given":"Giovanna","family":"Esposito","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edgardo","family":"Somigliana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Franchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Dallagiovanna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerio","family":"Pisaturo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Corrao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Parazzini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,7,9]]},"reference":[{"issue":"1","key":"2268_CR1","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1017\/thg.2015.96","volume":"19","author":"F Parazzini","year":"2016","unstructured":"Parazzini F, Cipriani S, Bianchi S, Bulfoni C, Bortolus R, Somigliana E. Risk of monozygotic twins after assisted reproduction: a population-based approach. Twin Res Hum Genet. 2016 Feb;19(1):72\u20136. https:\/\/doi.org\/10.1017\/thg.2015.96.","journal-title":"Twin Res Hum Genet"},{"issue":"2","key":"2268_CR2","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1016\/j.fertnstert.2018.10.025","volume":"111","author":"A Busnelli","year":"2019","unstructured":"Busnelli A, Dallagiovanna C, Reschini M, Paffoni A, Fedele L, Somigliana E. Risk factors for monozygotic twinning after in vitro fertilization: a systematic review and meta-analysis. Fertil Steril. 2019;111(2):302\u201317. https:\/\/doi.org\/10.1016\/j.fertnstert.2018.10.025.","journal-title":"Fertil Steril"},{"key":"2268_CR3","doi-asserted-by":"publisher","DOI":"10.1002\/tera.1420040214","volume-title":"The biology of twinning in man","author":"MG Bulmer","year":"1970","unstructured":"Bulmer MG. The biology of twinning in man. Oxford: Clarendon Press; 1970. https:\/\/doi.org\/10.1002\/tera.1420040214."},{"issue":"4","key":"2268_CR4","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1093\/humupd\/dmy006","volume":"24","author":"KVR Hviid","year":"2018","unstructured":"Hviid KVR, Malchau SS, Pinborg A, Nielsen HS. Determinants of monozygotic twinning in ART: a systematic review and a meta-analysis. Hum Reprod Update. 2018;24(4):468\u201383. https:\/\/doi.org\/10.1093\/humupd\/dmy006.","journal-title":"Hum Reprod Update"},{"key":"2268_CR5","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1007\/s43032-020-00406-0","volume":"28","author":"C Dallagiovanna","year":"2020","unstructured":"Dallagiovanna C, Vanni VS, Somigliana E, Busnelli A, Papaleo E, Villanacci R, et al. Risk factors for monozygotic twins in IVF-ICSI cycles: a case-control study. Reprod Sci. 2020;28:1421\u20137. https:\/\/doi.org\/10.1007\/s43032-020-00406-0.","journal-title":"Reprod Sci"},{"issue":"3","key":"2268_CR6","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1007\/s10815-014-0398-6","volume":"32","author":"F Parazzini","year":"2015","unstructured":"Parazzini F, Cipriani S, Bulfoni G, Bulfoni C, Frigerio A, Somigliana E, et al. The risk of birth defects after assisted reproduction. J Assist Reprod Genet. 2015 Mar;32(3):379\u201385. https:\/\/doi.org\/10.1007\/s10815-014-0398-6.","journal-title":"J Assist Reprod Genet"},{"key":"2268_CR7","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1007\/BF01671497","volume":"88","author":"W Weinberg","year":"1901","unstructured":"Weinberg W. Beitrage zur physiologie und pathologie der mehrlingsgeburten beim Menschen. Pflugers Archiv f\u00fcr Gesamte Pysiologie. 1901;88:346\u201350. https:\/\/doi.org\/10.1007\/BF01671497.","journal-title":"Pflugers Archiv f\u00fcr Gesamte Pysiologie"},{"issue":"11","key":"2268_CR8","doi-asserted-by":"publisher","first-page":"2435","DOI":"10.1093\/humrep\/dew216","volume":"31","author":"I Mateizel","year":"2016","unstructured":"Mateizel I, Santos-Ribeiro S, Done E, Van Landuyt L, Van de Velde H, Tournaye H, et al. Do ARTs affect the incidence of monozygotic twinning? Hum Reprod. 2016 Nov;31(11):2435\u201341. https:\/\/doi.org\/10.1093\/humrep\/dew216.","journal-title":"Hum Reprod"},{"issue":"1","key":"2268_CR9","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1097\/AOG.0000000000000579","volume":"125","author":"JR Kanter","year":"2015","unstructured":"Kanter JR, Boulet SL, Kawwass JF, Jamieson DJ, Kissin DM. Trends and correlates of monozygotic twinning after single embryo transfer. Obstet Gynecol. 2015 Jan;125(1):111\u20137. https:\/\/doi.org\/10.1097\/AOG.0000000000000579.","journal-title":"Obstet Gynecol"},{"issue":"2","key":"2268_CR10","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1016\/S0015-0282(00)00602-6","volume":"74","author":"LA Schieve","year":"2000","unstructured":"Schieve LA, Meikle SF, Peterson HB, Jeng G, Burnett NM, Wilcox LS. Does assisted hatching pose a risk for monozygotic twinning in pregnancies conceived through in vitro fertilization? Fertil Steril. 2000;74(2):288\u201394. https:\/\/doi.org\/10.1016\/S0015-0282(00)00602-6.","journal-title":"Fertil Steril"},{"issue":"3","key":"2268_CR11","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1007\/s10815-018-1118-4","volume":"35","author":"A Alteri","year":"2018","unstructured":"Alteri A, Vigan\u00f2 P, Maizar AA, Jovine L, Giacomini E, Rubino P. Revisiting embryo assisted hatching approaches: a systematic review of the current protocols. J Assist Reprod Genet. 2018 Mar;35(3):367\u201391. https:\/\/doi.org\/10.1007\/s10815-018-1118-4.","journal-title":"J Assist Reprod Genet"},{"key":"2268_CR12","unstructured":"Relazioni del Ministro della salute al Parlamento sullo stato di attuazione della legge contenente norme in materia di procreazione medicalmente assistita (Legge 19 febbraio 2004, n. 40, articolo 15). https:\/\/www.iss.it\/rpma-dati-registro. Accessed 31 Mar 2021"},{"issue":"2","key":"2268_CR13","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1016\/j.fertnstert.2016.06.029","volume":"106","author":"D Glujovsky","year":"2016","unstructured":"Glujovsky D, Farquhar C. Cleavage-stage or blastocyst transfer: what are the benefits and harms? Fertil Steril. 2016 Aug;106(2):244\u201350. https:\/\/doi.org\/10.1016\/j.fertnstert.2016.06.029.","journal-title":"Fertil Steril"},{"issue":"21","key":"2268_CR14","doi-asserted-by":"publisher","first-page":"00150","DOI":"10.1016\/j.rbmo.2021.04.001","volume":"S1472-6483","author":"T Eliasen","year":"2021","unstructured":"Eliasen T, Gabrielsen A, Bay B, Iversen L, Knudsen U. Monochorionic twins after single blastocyst transfer: retrospective cohort and blinded time lapse annotation analysis. Reprod BioMed Online. 2021;S1472-6483(21):00150\u20134. https:\/\/doi.org\/10.1016\/j.rbmo.2021.04.001.","journal-title":"Reprod BioMed Online"},{"issue":"3","key":"2268_CR15","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1016\/j.rbmo.2021.04.001","volume":"106","author":"J Otsuki","year":"2016","unstructured":"Otsuki J, Iwasaki T, Katada Y, Sato H, Furuhashi K, Tsuji Y, et al. Grade and looseness of the inner cell mass may lead to the development of monochorionic diamniotic twins. Fertil Steril. 2016;106(3):640\u20134. https:\/\/doi.org\/10.1016\/j.rbmo.2021.04.001.","journal-title":"Fertil Steril"}],"container-title":["Journal of Assisted Reproduction and Genetics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10815-021-02268-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10815-021-02268-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10815-021-02268-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T06:31:46Z","timestamp":1633415506000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10815-021-02268-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,9]]},"references-count":15,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["2268"],"URL":"https:\/\/doi.org\/10.1007\/s10815-021-02268-0","relation":{},"ISSN":["1058-0468","1573-7330"],"issn-type":[{"type":"print","value":"1058-0468"},{"type":"electronic","value":"1573-7330"}],"subject":[],"published":{"date-parts":[[2021,7,9]]},"assertion":[{"value":"1 April 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 June 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 July 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This analysis is exempt from IRB authorization and informed consent (according to General Authorization for the Processing of Personal Data for Scientific Research Purposes issued by the Italian Privacy Authority on December 15, 2016; home\/docweb\/-\/docweb-display\/docweb\/5805552). Data and permission for the analysis were obtained by the Regional Health Authorities of Lombardy, Italy.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Dr. Edgardo Somigliana reports grants from Ferring, grants and personal fees from Merck-Serono, grants and personal fees from Theramex, personal fees from Gedeon-Richter, outside the submitted work. Prof. Giovanni Corrao received research support from the European Community (EC), the Italian Agency of Drugs (AIFA), and the Italian Ministry for University and Research (MIUR). He took part in a variety of projects that were funded by pharmaceutical companies (i.e., Novartis, GSK, Roche, AMGEN, and BMS). He also received honoraria as a member of the advisory board to Roche. All the other authors declare that they have no conflicts of interest to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}