In Vitro Fertilization with Dichorionic-Diamniotic Twin Pregnancies: A Retrospective Study Comparing Pregnancy Outcomes of Advanced Maternal Age and Age-Appropriate nulliparous women

Objective and Significance: This study aims to compare the pregnancy outcomes of advanced maternal age and age-appropriate nulliparous women undergoing in vitro fertilization (IVF) with dichorionic-diamniotic twin pregnancies (DCDA). Methods A total of 141 nulliparous women who underwent cesarean section due to IVF DCDA twin pregnancies at the Second People's Hospital of Nanning between January 2020 and August 2024 were analyzed. The advanced maternal age group consisted of 47 cases, while the age-appropriate group comprised 94 cases, with propensity score matching (PSM) applied. We observed parameters including body mass index (BMI), parity, age at menarche, gestational week at delivery, preterm birth (PTB), premature rupture of membranes (PROM), low birth weight (LBW), twin growth discordance, intraoperative blood loss, hemoglobin levels in early and late pregnancy, placenta previa, placental abruption, hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), intrahepatic cholestasis of pregnancy (ICP), and postpartum hemorrhage (PPH). Results The advanced maternal age group exhibited higher rates of twin growth discordance and intraoperative blood loss compared to the age-appropriate group, with statistically significant differences (P < 0.05). However, no significant differences were observed between the groups regarding PTB, LBW, placenta previa, placental abruption, GDM, HDP, ICP, and PPH. Conclusion Advanced maternal age nulliparous women undergoing IVF with DCDA twin may face higher risks of twin growth discordance and intraoperative blood loss, but there are no significant differences in other pregnancy complications and outcomes compared to age-appropriate nulliparous women. This suggests that with proper monitoring during pregnancy, favorable outcomes can be achieved in advanced maternal age nulliparous women undergoing IVF with DCDA twin pregnancies.