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Neurological sequelae in twins born after assisted conception: controlled national cohort study

BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.38156.715694.3A (Published 05 August 2004) Cite this as: BMJ 2004;329:311

Rapid Response:

One nest, one egg, one offspring and one natural human couple!

Sir:

Both the editorial [1] and the related study [2] make a very
interesting reading and are further thought provoking. The editorialists
suggested strongly that one nest and one egg is ideal for one offspring
and medically strongly compatible. We further add that one egg and one
nest should have one natural human young couple in order to avoid most but
not all adverse consequences of assisted conceptions by in vitro
fertilization [IVF] and intracytoplasmatic sperm injection [ICSI].

This controlled study informed the readers about two major findings;
twins from assisted conception have a similar risk of neurological
sequelae as their naturally conceived peers and singletons from assisted
conception and children born after ICSI have the same risk of neurological
sequelae as children born after IVF. However, low birth weight and preterm
birth were insignificantly more common among twins born after assisted
conception than the naturally born twins. Hospital stay was longer in
assisted conception born twins. Surprisingly and unexpectedly, perinatal
infant and infant mortality was more common among naturally born twins
than the assisted conception born twins and singletons.

These findings have some implications; the females would further
delay natural pregnancies or even marriages in order to enjoy their life,
knowing that twins or singletons born after assisted conception which can
be realized at any time in life are not vulnerable to and rather safe from
developing any neurological complications and sequelae; and IVF and ICSI
clinics would boom in future, which if run most by private sector will
result in huge financial burden to the couple including infertile ones.

Finally, one egg, one nest and one offspring from one natural young
couple is ideal and highly recommended.

References:

1. Marc J N C Keirse and Frans M Helmerhorst.How many eggs?. BMJ 2004
329: 302-303.

2.Anja Pinborg, Anne Loft, Lone Schmidt, Gorm Greisen, Steen
Rasmussen, and Anders Nyboe Andersen. Neurological sequelae in twins born
after assisted conception: controlled national cohort study. BMJ 2004;
329: 311-0.

Competing interests:
None declared

Competing interests: No competing interests

14 August 2004
Dr. Naseem A. Qureshi, MD, IMAPA, LMIPS
Medical Director [A], Director, CME&R
Buraidah Mental Health Hospital, Postcode.2292, Saudi Arabia