There is a paucity of evidence describing future reproductive outcomes in women who have had selective fetoscopic laser photocoagulation (SFLP) for twin-twin transfusion syndrome (TTTS). Our study aims to compare these outcomes following exposure to SFLP to outcomes following a monochorionic multiple gestation with no SFLP.METHODS:
This is a retrospective cohort study which analyzed records of patients who were evaluated at the Cincinnati Fetal Center (2007-2014) for monochorionic multiple gestations. A questionnaire regarding reproductive and gynecologic outcomes following the index pregnancy was administered to participants by electronic distribution or by mail. Subsequent pregnancy and gynecologic outcome data was compared between pregnancies with prior SFLP vs no prior SFLP.RESULTS:
There was a higher response rate in the SFLP group (150/355, 42.3%) vs the referent group (60/187, 32.1%). Approximately 38% of women in both groups attempted conception after the index pregnancy with a greater than 90% pregnancy success rate. Use of ART was highly prevalent in both the index and subsequent pregnancies with no significant difference between groups. The median interpregnancy interval for the entire cohort was between 1-2 years. Over 60% of women in each group did not attempt future pregnancy. Roughly 1 in 3 women cited the outcome of the index pregnancy as the primary reason for not pursuing future conception. There were no significant differences in selected maternal-fetal complications and new onset gynecologic problems.CONCLUSION:
SFLP for TTTS does not appear to be associated with adverse reproductive outcomes. Our data will help facilitate evidence-based counseling for this patient population.