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Open research questions in Assisted Reproductive Technology and Twin Pregnancy

32 unresolved questions extracted from the limitations and future-work sections of 580 Assisted Reproductive Technology and Twin Pregnancy papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • The development of digital twin obstetrics requires modeling strategies capable of handling heterogeneous, high-dimensional, longitudinal, and partially missing data. Traditional statistical models, such as logistic regression and Cox regression, remain important because they are interpretable, transparent, and familiar to clinicians. They are particularly useful when sample sizes are modest and the number of predictors is limited.

    From virtual pregnancy to digital twin obstetrics: multimodal data integration for personalized prediction of pregnancy complications · 2026 · DOI

  • Future research should prioritize several directions. First, large prospective longitudinal pregnancy cohorts are needed, with stan- dardized clinical data, imaging, biospecimens, and continuous moni- toring data collected across gestation. Pregnancy-specific transcriptomic and wearable studies show the value of longitudinal data, but future cohorts must link these modalities within the same individuals and clinical decision windows (29, 30, 36). Second, mul- timodal data standards and interoperable pipelines should be devel- oped so that clinical, imaging, omics, and wearable features can be harmonized across sites rather than assembled as ad hoc datasets (37, 40, 41).

    From virtual pregnancy to digital twin obstetrics: multimodal data integration for personalized prediction of pregnancy complications · 2026 · DOI

  • Long-term neonatal and childhood cardiovas- cular follow-up was not performed, and the prognos- tic significance of the observed MPI elevation remains unknown. Several limitations of this study should be acknowl- edged.

    Fetal cardiac function in ICSI-conceived pregnancies: a case–control study using MAPSE, TAPSE, and myocardial performance index · 2026 · DOI

  • Further research should apply techniques such as sequential SFLP to re-balance blood volume distribution and thus improve kidney perfusion sooner after surgery.

    Twin-to-twin transfusion syndrome and neonatal acute kidney injury after selective fetoscopic laser photocoagulation · 2026 · DOI

  • Many maternal-fetal dyads who underwent SFLP at the institution subsequently returned to their referring centers for delivery, resulting in incomplete data capture.

    Twin-to-twin transfusion syndrome and neonatal acute kidney injury after selective fetoscopic laser photocoagulation · 2026 · DOI

  • It has been reported that early well-timed diagnosis of the disease is very important for reducing fetal adverse events Because of the rarity, the literature is limited to the description of small series or case reports of twins affected by TAPS.

    Antenatal management of twin anemia-polycythemia sequence · 2018 · DOI

  • However, its clinical significance remains uncertain and requires external validation together with correlation to prenatal and postnatal outcomes before any clinical application.

    Volume-corrected renal arterial pulsatility index in IVF-ET fetuses and naturally conceived fetuses: establishing reference ranges and correlation with gestational age · 2026 · DOI

  • Limitations, reasons for caution: Findings are limited to individuals born in mid-20th-century Finland and thus generalizability to recent populations or non-Nordic contexts may be restricted.

    Fertility rates across generations in twins and singletons: A total population study in Finland · 2026 · DOI

  • The population may be skewed toward more complex cases, since patients with complicated post-procedural courses are more likely to remain in the quaternary center's care.

    Twin-to-twin transfusion syndrome and neonatal acute kidney injury after selective fetoscopic laser photocoagulation · 2026 · DOI

  • Several studies have been performed regarding the success of transplacental anti-arrhythmic therapy in singleton pregnancies, but information on the management of multifetal gestation affected by fetal tachycardia is scarce.

    Transplacental therapy of supraventricular tachycardia and hydrops fetalis in a twin pregnancy – case report and literature review · 2021 · DOI

  • Further research into the relationship between maturity markers such as the Ballard score and the rates of death and specific premature related illnesses is warranted.

    A Comparison of the Accuracy of Various Methods of Postnatal Gestational Age Estimation; Including Ballard Score, Foot Length, Vascularity of the Anterior Lens, Last Menstrual Period and Also a Clinician’s Non-Structured Assessment · 2020 · DOI

  • Preterm labor remains to be one of the most important challenges of contemporary perinatology and constitutes the main reason of perinatal mortality and prematurity of neonates.

    Ultrasound evaluation of fetal adrenal gland volume. The role of fetal adrenal glands in the pathogenesis of preterm labor · 2014 · DOI

  • The lack of consensus regarding nomenclature and classification of pregnancy loss prior to viability makes it difficult to compare study results from different centres.

    Terminology for pregnancy loss prior to viability: a consensus statement from the ESHRE early pregnancy special interest group · 2014 · DOI

  • Moreover, embryo culture media and their effects need to be investigated thoroughly to select the best embryo culture medium in order to minimize or prevent short-term risks and maybe even long-term disease susceptibility.

    Further evidence that culture media affect perinatal outcome: findings after transfer of fresh and cryopreserved embryos · 2012 · DOI

  • INTRODUCTION: Even though placentas from assisted reproduction programs often differ from placentas of women who conceived naturally, they are rarely examined.

    Gross characteristics of placentas from an assisted reproduction program · 2006 · DOI

  • If successful pregnancies are underreported at a specific gestation age, the corresponding denominator de- creases and the probability estimate is again biased upward.

    Spontaneous fetal death in man · 1973 · DOI

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32 open questions have been extracted from the limitations and future-work passages of 580 Assisted Reproductive Technology and Twin Pregnancy papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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