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Open research questions in Assisted Reproductive Technology and Twin Pregnancy

155 unresolved questions extracted from the limitations and future-work sections of 795 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 study was retrospective, - the study only included women undergoing IUI treatment, - the study had a limited sample size for obese women (only 81 live births)

    Preconception maternal body mass index and offspring sex ratio in intrauterine insemination cycles · 2026 · DOI

  • further studies are needed to explore the mechanisms underlying the association between maternal preconception BMI and offspring sex, - studies should investigate whether the findings are generalizable to other populations, such as women conceiving spontaneously

    Preconception maternal body mass index and offspring sex ratio in intrauterine insemination cycles · 2026 · DOI

  • There is a lack of clarity on the relationship between ART and perinatal emotional wellbeing. Prior studies have reported conflicting findings, reflecting gaps in methodology and measurement.

    Assisted reproduction and perinatal emotional wellbeing: findings from a longitudinal study · 2024 · DOI

  • Assisted reproductive technology (ART) increases the incidence of MC twinning, but its impact on pregnancy outcomes in this subgroup remains unclear.

    Monochorionic twin pregnancies conceived through assisted reproduction: Maternal and perinatal clinical outcomes · 2026 · DOI

  • Although several phenotypes have been described, the full clinical and molecular spectrum remains poorly defined.

    Clinical and Genotypic Spectrum of Twinkle-Related Disorders · 2026 · DOI

  • INTRODUCTION: Pregnancies at very and extremely advanced maternal age (VAMA, 45-49 years and EAMA, ≥50 years) are increasingly common, particularly regarding the influence of assisted reproductive technology (ART), yet their obstetric and perinatal outcomes remain underexplored.

    Perinatal outcomes in pregnancies with very and extremely advanced maternal age: An Italian multicenter retrospective cohort study · 2025 · DOI

  • However, the differences in growth between ART and natural pregnancy (NP) infants remain controversial.

    A comparative study on infant growth between assisted reproductive technology pregnancy and natural pregnancy · 2025 · DOI

  • Furthermore, the study does not address the outcome of the spontaneous breech deliveries of the second twin in order to discuss the pros and cons for trial of ECV, nor is the indication for cesarean section in failed ECVs discussed, and it remains unclear whether vertex presentation of the second twin would have made a difference.

    What to do when the second twin is non‐vertex? · 2025 · DOI

  • Long-term follow-up is warranted to assess the overall health status associated with ART throughout the lifespan.

    Comprehensive Health Assessment of School‐Age Children Conceived by Assisted Reproductive Technology: A Prospective Cohort Follow‐Up Study · 2025 · DOI

  • Studies show IPI affects adverse outcomes in singleton pregnancies, but its impact on twin pregnancies remains unclear.

    Relationship between inter-pregnancy interval and risk of adverse maternal and neonatal outcomes in subsequent twin pregnancies · 2025 · DOI

  • While double cleavage-stage and single blastocyst transfers are common, limited data exists on the intermediate strategy of single morula transfer.

    Elective single morula transfer achieved better clinical outcomes than two cleavage embryos transfer in fresh IVF-ET cycles · 2025 · DOI

  • All twin pregnancies > 14 weeks' gestation in whom chorionicity had not been determined and without any complications were included.

    Accuracy of second and third trimester ultrasound in the determination of chorionicity in twin pregnancies: a cross-sectional observational study · 2025 · DOI

  • The coagulation functions of the surviving fetus and mother remain controversial.

    The term cotwin with spatial pulmonary lesions and elevated maternal-neonatal D-dimer levels following single intrauterine fetal death in a monochorionic-monoamniotic twin pregnancy: a case report and literature review · 2025 · DOI

  • BACKGROUND: Although years have passed since the implementation of China's universal two-child policy, the effectiveness of this policy remains unclear.

    The impact of China's universal two-child policy on total, preterm, and multiple births: a nationwide interrupted time-series analysis · 2024 · DOI

  • However, the impact of ART on the immune system of children remains poorly understood.

    Immune profiling of ART-conceived children in Kazakhstan: a case-control study · 2024 · DOI

  • However, due to the limited number of triplet pregnancies, further exploration of the underlying mechanism is warranted.

    Perinatal outcomes and growth discordance of triplet pregnancies based on chorionicity: a retrospective cohort study · 2024 · DOI

  • However, the clinical significance of uniparental disomy and the difference among the prognosis of involvement of different chromosomes remain unclear.

    Prenatal ultrasound findings and clinical outcomes of uniparental disomy: a retrospective study · 2024 · DOI

  • Further investigation into the potential additive risk of ART and placental abruption is needed.

    Risks of Placental Abruption and Preterm Delivery in Patients Undergoing Assisted Reproduction · 2024 · DOI

  • Furthermore, prior epidemiologic studies only assessed fetuses at birth and did not account for potential fetal reductions that may have been performed earlier in pregnancy.

    Multifetal Pregnancy After Implementation of a Publicly Funded Fertility Program · 2024 · DOI

  • The incidence of AKI after SFLP for TTTS is not well characterized. There is a need to identify factors associated with AKI after SFLP for TTTS.

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

  • The complexity of cerebral palsy diagnosis and classification. The need for large, population-based datasets to examine the association between fertility treatment and cerebral palsy. The potential for biases and errors in linked population-based data.

    Fertility treatment and risk of cerebral palsy: has the association changed in Australia? · 2026 · DOI

  • The study is limited to data from Western Australia. The study does not examine the underlying causes of cerebral palsy. The study relies on linked population-based data, which may be subject to biases and errors.

    Fertility treatment and risk of cerebral palsy: has the association changed in Australia? · 2026 · DOI

  • The pathogenesis of the TRAP sequence remains unclear. There is a need for early diagnosis and treatment of this condition.

    Case Report: Missed diagnosis of twin reversed arterial perfusion sequence discovered at delivery: lessons from poorly monitored monochorionic twin pregnancy · 2026 · DOI

  • The effectiveness of serial versus once-only cervical length screening in twin pregnancies is unknown. There is a need to compare the sensitivity and specificity of cervical length screening for predicting preterm birth in twin pregnancies.

    Serial versus once-only cervical length screening in twin pregnancies · 2026 · DOI

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155 open questions have been extracted from the limitations and future-work passages of 795 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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