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The timing of the "fertile window" in the menstrual cycle: day specific estimates from a prospective study BMJ 2000; 321: 1259-1262. Effects on the probability of conception, survival of the pregnancy, and sex of the baby.

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American College of Obstetricians and Gynecologists. Clinical management guidelines for obstetrician-gynecologists. Twin pregnancy: the role of ultrasound in management. Ameri-can College of Obstetricians and Gynecologists. The earlier age at delivery of multiple gestations is a reflection of the increased incidence of preterm labor and obstetric intervention for complications such as preeclampsia, abruptio placentae, fetal growth restriction, and increased risk for stillbirth that occurs as the number of fetuses increases [30-33]. Mongelli M, Wilcox M, Gardosi J.: Estimating the date of confinement: ultrasonographic biometery versus certain menstrual dates.

The tendency for multiple gestations to be delivered earlier than singleton pregnancies should not be interpreted that multiples should be assigned an earlier estimated due date.

The American College of Obstetricians and Gynecologists.

Berghella V, et al., Does transvaginal sonographic measurement of cervical length before 14 weeks predict preterm delivery in high-risk pregnancies?

The gestational age would, therefore, be at least 3 to 4 weeks at the time of a reliable h CG pregnancy test.

Twins When a twin pregnancy is the result of in vitro fertilization determination of gestational age should be made from the date of embryo transfer. Clinical management guidelines for obstetricians-gynecologists. Number 55, September 2004 (replaces practice pattern number 6, October 1997).

Otherwise "..avoid missing a situation of early intrauterine growth restriction in one twin, most experts agree that the clinician may consider dating pregnancy using the larger fetus." [22,23].