Obstetrics and Gynecology Science最新文献

{"title":"Innovations in assisted reproductive technologies: evaluating efficacy, safety, and long-term outcomes in female infertility.","authors":"Hakimeh Akbari","doi":"10.5468/ogs.25264","DOIUrl":"10.5468/ogs.25264","url":null,"abstract":"<p><p>This narrative review evaluates innovations in assisted reproductive technology (ART) for female infertility, focusing on efficacy, safety, and long-term outcomes. The key objectives include synthesizing advancements such as artificial intelligence (AI)-driven embryo selection, preimplantation genetic testing (PGT), vitrification, and time-lapse imaging, along with their clinical applications. Evidence indicates that PGT can improve implantation and live birth rates per transfer in selected patient groups, that is, those with recurrent pregnancy loss or advanced maternal age. Evidence of AI-assisted selection is promising, but predominantly retrospective, with the potential to improve the efficiency of embryo selection, but has not yet been proven across a variety of clinical settings. However, safety concerns, including ovarian hyperstimulation syndrome, multiple pregnancies, and potential long-term maternal and offspring health risks, persist. Critical reflections highlight ethical dilemmas (e.g., \"designer babies\", embryo disposition), psychological stressors for patients, and disparities in ART access due to socioeconomic factors. This review underscores the need for personalized protocols, robust longitudinal studies on child development, and equitable policy frameworks. These conclusions advocate for interdisciplinary collaboration to balance technological innovation with ethical integrity, psychological support, and global accessibility.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"39-52"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of serum Netrin-1 and urinary kidney injury molecule-1 in risk stratification of preeclampsia.","authors":"Adhibha Babu T, Meenakshi Gothwal, Maithili Karpaga Selvi, Garima Yadav, Charu Sharma, Pratibha Singh","doi":"10.5468/ogs.25298","DOIUrl":"10.5468/ogs.25298","url":null,"abstract":"<p><strong>Objective: </strong>Preeclampsia (PE) is a leading cause of maternal and perinatal morbidity and mortality worldwide. Identifying reliable biomarkers may improve risk prediction and disease stratification. To evaluate serum Netrin-1 and urinary kidney injury molecule-1 (KIM-1) levels in preeclamptic women compared with those in healthy pregnant women and to assess their association with disease severity and maternal-fetal outcomes.</p><p><strong>Methods: </strong>A prospective observational study was conducted at a tertiary care referral center in Western Rajasthan between September 2023 and March 2025, enrolling 118 pregnant women (59 PE cases and 59 controls). Serum Netrin-1 and urinary KIM-1 levels were correlated with PE severity, maternal complications, and fetal outcomes.</p><p><strong>Results: </strong>Preeclamptic women had significantly higher serum Netrin-1 (844.55±195.27 pg/mL) and urinary KIM-1 (1.57±0.75 ng/mg creatinine) levels than controls (378.24±127.75 pg/mL and 0.62±0.29 ng/mg; P<0.0001). Biomarker levels were higher in patients with severe PE and maternal complications. Receiver operating characteristic curve analysis demonstrated excellent diagnostic accuracy for serum Netrin-1 (area under the curve [AUC], 0.993) and very good accuracy for urinary KIM-1 (AUC, 0.916).</p><p><strong>Conclusion: </strong>Serum Netrin-1 and urinary KIM-1 levels are promising biomarkers for PE diagnosis and risk stratification. Serum Netrin-1 levels show excellent discriminatory potential and may support clinical risk prediction.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"65-71"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of Cripto-1 protein in placentas from term pregnancies with and without fetal growth restriction: a retrospective cohort study in Croatia.","authors":"Pavo Perković, Andrea Dekanić, Marina Perković, Vesna Vukičević Lazarević, Tomislav Perković, Tea Štimac","doi":"10.5468/ogs.25227","DOIUrl":"10.5468/ogs.25227","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated Cripto-1 expression, a crucial regulator of epithelial-mesenchymal transition (EMT) and trophoblast differentiation, in term placentas from pregnancies complicated by fetal growth restriction (FGR), compared with healthy term placentas. We hypothesized that Cripto-1 expression is reduced in FGR placentas, reflecting impaired EMT.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using 153 term placental samples collected between 2016 and 2020 at the Clinical Hospital Center Rijeka, Croatia. This study included 122 placentas from pregnant women with FGR and 31 placentas from gestational age-matched controls. Cripto-1 expression was evaluated using tissue microarrays and the immunohistochemical index was calculated by multiplying the staining intensity reaction by the percentage of positive cells. Clinical data were retrieved from medical records and included maternal age, parity, preeclampsia status, serum beta-human chorionic gonadotropin and pregnancy-associated plasma protein-A levels, ultrasound fetal biometry, Doppler measurements of the umbilical artery and fetal circulation, fetal sex, weight, fetoplacental ratio, and placental histopathological findings.</p><p><strong>Results: </strong>Maternal age, parity, and neonatal birth weight differed significantly between the FGR and control groups. However, no statistically significant differences in Cripto-1 expression were detected between the FGR and healthy placentas. Additionally, Cripto-1 expression was not associated with any of the clinical or biochemical parameters measured in the FGR group.</p><p><strong>Conclusion: </strong>Cripto-1 expression did not differ significantly between placentas with FGR, suggesting that its role may be more relevant in early placental development. Further studies are warranted to determine its value as an early biomarker of placental dysfunction.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"53-64"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fertility knowledge and employment status among Japanese pregnant women: J-PEARL study.","authors":"Kyoko Namimatsu, Jun Takeda, Motoki Endo, Yuito Ueda, Shintaro Makino, Takeshi Tanigawa, Atsuo Itakura","doi":"10.5468/ogs.25146","DOIUrl":"10.5468/ogs.25146","url":null,"abstract":"<p><strong>Objective: </strong>Despite recent improvements, fertility knowledge among Japanese individuals remains substantially lower than in other countries. This study aimed to evaluate fertility knowledge among women with pregnancy and childbirth experience and assess differences based on employment status, given the increasing intersection of professional careers and reproductive decision making.</p><p><strong>Methods: </strong>A cross-sectional, multicenter questionnaire survey was administered to postpartum women at seven hospitals. The questionnaire assessed clinical and socioeconomic characteristics and incorporated the Cardiff fertility knowledge scale-Japanese version (CFKS-J). Participants were categorized as employed or non-employed and CFKS-J scores were calculated for both groups. Factors associated with greater fertility knowledge in each group were analyzed.</p><p><strong>Results: </strong>Of the 963 postpartum women who participated in this study, 81% were employed during pregnancy. Employed participants had significantly higher fertility knowledge scores (60.0±21.5) than non-employed participants (55.8±22.8; P=0.03). Healthcare workers had the highest knowledge about fertility. Common misconceptions included the effects of mumps, obesity, and sexually transmitted diseases on fertility.</p><p><strong>Conclusion: </strong>Employed pregnant women had greater fertility knowledge than non-employed women. Factors linked to knowledge acquisition included education and the workplace environment. Improving access to fertility education among socially isolated groups, including the unemployed, remains essential.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"473-482"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12645006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovations in assisted reproductive technology through the advances in artificial intelligence and image processing.","authors":"Dayong Lee","doi":"10.5468/ogs.25229","DOIUrl":"10.5468/ogs.25229","url":null,"abstract":"<p><p>Advances in artificial intelligence (AI) and biomedical imaging have transformed reproductive medicine, offering new avenues for precision, efficiency, and objectivity in assisted reproductive technology (ART). Traditional embryo selection and ovarian stimulation monitoring rely mainly on subjective interpretation, which is often influenced by inter- and intra-observer variability. In contrast, AI-enhanced models have demonstrated consistent performance, reduced human-dependent discrepancies, and improved reproducibility of clinical decisions. Among emerging technologies, fluorescence lifetime imaging microscopy enables real-time, label-free metabolic assessment of gametes and embryos by quantifying the intrinsic fluorescence lifetimes of nicotinamide adenine dinucleotide phosphate and flavine adenine dinucleotide. These metabolic signatures correlate with developmental competence, providing a non-invasive tool to evaluate embryo quality beyond the morphological criteria. Recent innovations have extended AI and imaging technologies to self-operated reproductive health monitoring. Studies support AI-powered self-assessment of ovarian follicles using smartphone-compatible ultrasound devices and automated follicle segmentation. This development has potential for improving ovarian stimulation tracking, patient engagement, and personalizing treatment protocols in clinical and low-resource settings. The integration of AI, advanced image processing, and metabolic imaging is a promising frontier in reproductive medicine. These tools enhance the precision of embryo and follicle evaluation, while establishing foundations multimodal platforms that combine clinical, morphological, and metabolic data to optimize ART outcomes.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"458-466"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12645012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Red blood cell indices as predictor for severity of endometriosis.","authors":"Josua Simanjuntak, Edy Priyanto, M Alamsyah Azis","doi":"10.5468/ogs.25080","DOIUrl":"10.5468/ogs.25080","url":null,"abstract":"<p><strong>Objective: </strong>Endometriosis is the presence of endometrial tissue outside of the uterine cavity. Certain markers have been used to evaluate the severity of endometriosis. This study aimed to explore the correlation between red blood cell (RBC) indices and the severity of endometriosis.</p><p><strong>Methods: </strong>This was a cross-sectional study including 200 patients with endometriosis (stage I-II and stage III-IV groups) and 100 patients with other benign ovarian tumors who underwent laparotomy at the Department of Obstetrics and Gynaecology, Margono Regional Public Hospital, between 2021 and 2024. Blood tests were evaluated before surgery and the severity of endometriosis was determined during surgery using the revised American Society for Reproductive Medicine classification.</p><p><strong>Results: </strong>Among the obtained RBC indices, mean hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) values were significantly lower in subjects with stage III-IV endometriosis than in those with stage I-II endometriosis and the control group (P=0.000, P=0.000, P=0.006, and P=0.010, respectively). The mean red cell distribution width (RDW) was significantly higher in the stage III-IV group than in the stage I-II and control groups (P=0.000). In addition, univariate analysis indicated that lower preoperative RBC indices (Hb ≤11.9 g/dL, Hct ≤37.1%, MCV ≤82.6 fL, MCH ≤26.6 pg) and higher RDW ≥14.9% were independent risk factors for stage III/IV endometriosis.</p><p><strong>Conclusion: </strong>Lower RBC indices, including pre-operative Hb, Hct, MCV, and MCH, were significantly associated with the severity of endometriosis, which is potentially caused by dysregulation of iron metabolism and inflammation.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"519-524"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12644974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single port access laparoscopic fundusectomy, more efficient uterus-sparing surgical method for multiple fibroids in patient with no pregnancy plan.","authors":"Jae Hyeok Jeong, Yoo Ri Kim, Bo Ram Kim, Ji Won Lee, Seung Yeon Oh, Jeong Hye Yun, Myoung Seok Han, Eun Jeong Kim, Yong Jung Song","doi":"10.5468/ogs.25113","DOIUrl":"10.5468/ogs.25113","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to introduce the clinical experience with a new surgical technique, single-port access laparoscopic fundusectomy, and a more efficient uterus-sparing surgical method for treating multiple fibroids in patients without a pregnancy plan.</p><p><strong>Methods: </strong>We performed single-port access laparoscopic myomectomy in 228 patients and single-port access laparoscopic fundusectomy in 35 patients and compared the surgical outcomes.</p><p><strong>Results: </strong>Significant differences in the surgical outcomes were observed between the two operating.</p><p><strong>Methods: </strong>. Operating time was 150.71±24.5 minutes in the fundusectomy group than 172.13±61.30 minutes in the multiple myomectomy group (P-value 0.042). Estimated blood loss was lesser (198.29±90.53 mL) in the fundusectomy group than (314.04±344.56 mL) in the multiple myomectomy group (P-value 0.049).</p><p><strong>Conclusion: </strong>This experience suggests that single-port access laparoscopic fundusectomy is more effective than single-port access laparoscopic myomectomy in terms of operating time and estimated blood loss.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"525-534"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12645014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative outcomes of excision and active surveillance for cervical intraepithelial neoplasia 2 in women under 35: a single institutional retrospective study.","authors":"Jihyun Lee, Mi Song Kim, Ju-Won Roh, Kyung Hee Han","doi":"10.5468/ogs.25100","DOIUrl":"10.5468/ogs.25100","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the outcomes of excision (conization) and active surveillance in women under 35 years of age diagnosed with cervical intraepithelial neoplasia 2 (CIN 2) on disease regression to normal cervical cytology and the effectiveness of nonsurgical management.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at CHA University Ilsan Medical Center. Women under 35 diagnosed with CIN 2 were included and divided into two groups based on the management strategy: excisional treatment or active surveillance. Data on patient outcomes, including the regression time to normal cytology, were retrospectively collected and analyzed.</p><p><strong>Results: </strong>The follow-up period ranged from 2.73 months to 42.6 months, with a median follow-up period of 6.8 months. Management strategies between the excisional procedure and active surveillance were not associated with the cytological normalization from CIN 2 (P=0.32). The median time to achieve normal cytology was 7.4 months (95% confidence interval [CI], 6.08-8.77) in the excision group and 12.8 months (95% CI, 10.34-15.22) in the active surveillance group (P=0.22). This trend was observed across the following age groups: 20-24, 25-29, and 30-34 years (20-24, P=0.96; 25-29, P=0.67; and 30-34, P=0.99).</p><p><strong>Conclusion: </strong>There was no significant difference between the excisional procedure and active surveillance in terms of achieving normalized cytology from CIN 2. Active surveillance is a feasible option for managing CIN 2 in women under 35 years of age.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"483-490"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12644976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of intrauterine lidocaine compared to warm isotonic sodium chloride solution for the control of pain during office hysteroscopy: a randomized controlled trial.","authors":"Amira Shoab, Amira H AbdelAziz, Hesham El-Shaer, Ahmed M Maged, Wael El-Sherbiny","doi":"10.5468/ogs.25131","DOIUrl":"10.5468/ogs.25131","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effectiveness of intrauterine lidocaine and warm isotonic sodium chloride solution as distension media for pain reduction during office hysteroscopy.</p><p><strong>Methods: </strong>This triple-blind randomized controlled trial included 100 patients undergoing diagnostic office hysteroscopy. They were randomized into either the isotonic sodium chloride solution group, which underwent hysteroscopy using warmed isotonic sodium chloride solution as the distension medium, or the lidocaine group, which underwent hysteroscopy using 5 mL of 2% lidocaine diluted in warmed isotonic sodium chloride solution as the distension medium. The primary outcome was the pain visual analog scale score during and after the procedure.</p><p><strong>Results: </strong>The pain score reported throughout the procedure (during insertion, visualization and withdrawal) and 15 minutes after the procedure was significantly lower in women in the lignocaine group compared to the other group (1.9±1.0 vs. 3.1±0.8, 1.5±0.8 vs. 2.5±0.8, 1.7±0.8 vs. 2.8±0.7, and 1.1±0.2 vs. 1.7±0.8, respectively). Regarding complications, there were no differences between the two study groups in reported vaginal bleeding (1 vs. 2) or vasovagal reaction (0 vs. 1) with no reported cases of uterine perforation or creation of false tract. Regarding side effects, there were a significantly lower number of women who experienced lower abdominal pain, nausea and headache in the lignocaine group compared to others.</p><p><strong>Conclusion: </strong>The addition of lidocaine to isotonic sodium chloride solution as the distension medium during office hysteroscopy was associated with low pain scores during and after the procedure, short procedure time, reduced need for additional analgesia, high patient satisfaction, and low procedural difficulty scores.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"512-518"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12645007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145348990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstetric and perinatal outcomes in twin pregnancies conceived via assisted reproductive technology vs. spontaneous conception: a population-based cohort study.","authors":"Eunhee Yu, Hyun Joo Lee, Sul Lee, Seung Chul Kim, Jong Kil Joo","doi":"10.5468/ogs.25201","DOIUrl":"10.5468/ogs.25201","url":null,"abstract":"<p><strong>Objective: </strong>To compare obstetric and perinatal outcomes between assisted reproductive technology (ART)-conceived and spontaneously conceived twin pregnancies using a nationwide Korean cohort.</p><p><strong>Methods: </strong>This retrospective cohort study used Korean National Health Insurance Service data from October 2017 to December 2021. Twin pregnancies were identified via International Classification of Diseases, 10th revision codes and classified by conception type based on embryo transfer procedure codes. Outcomes included miscarriage, preeclampsia, placenta previa, gestational diabetes mellitus (GDM), emergency cesarean section (CS), intrauterine growth restriction (IUGR), and macrosomia. Multivariable logistic regression was used to calculate adjusted odds ratios (aORs), controlling for maternal age and comorbidities. Subgroup analyses stratified by maternal age were also performed.</p><p><strong>Results: </strong>Among 36,013 twin pregnancies, those conceived via ART showed higher risks of placenta previa (aOR, 1.81; 95% confidence interval [CI], 1.57-2.08), preeclampsia (aOR, 1.31; 95% CI, 1.17-1.47), GDM (aOR, 1.32; 95% CI, 1.22-1.43), emergency CS (aOR, 1.21; 95% CI, 1.08-1.34), and IUGR (aOR, 1.18; 95% CI, 1.07-1.31). In women ≥35 years, risks were more pronounced for preeclampsia (aOR, 1.38; 95% CI, 1.19-1.61) and emergency CS (aOR, 1.22; 95% CI, 1.06-1.42).</p><p><strong>Conclusion: </strong>Twin pregnancies conceived via ART are associated with significantly increased risks of obstetric and perinatal complications compared with spontaneous conceptions. Given the growing utilization of ART, these findings underscore the importance of individualized prenatal care and vigilant perinatal monitoring in ART-conceived twin pregnancies, particularly among women of advanced maternal age.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"491-502"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12645013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}