During the last decades, assisted reproductive technique has been transformed from a miracle to real and has become widely used for treatment human infertility.

this was associated with increased the rate of twin pregnancies

Twin pregnancies are associated with an increased risk of maternal mortality & morbidity and an increase in the incidence of neonatal morbidity and mortality compared to singleton pregnancy.

The heterogeneous results reported so far can also depend on differences in the studied populations and/or in the management approach to twin pregnancy, variability in data regarding neonatal and maternal outcomes.

Evidence on pregnancy outcomes of twins conceived by artificial reproductive technology (ART) compared with those naturally conceived (NC) is conflicting, A 2004 systematic review and a large 2008 study both were praised that in cases of twin pregnancy after assisted conception the perinatal mortality is significantly lower, when compared with those spontaneously conceived .

Inclusion Criteria:

• Twin delivered >24-week gestational age
• weight ≥ 500g
• Diachronic diamniotic twins.

Exclusion Criteria:

• Intrauterine fetal deaths
• Higher-order multiple pregnancies
• Deliveries complicated by early vanishing fetuses
• Twin pregnancies reduced to singleton
• Triple pregnancy reduced to twin.

Twin delivery was identified when coming to outpatient clinic & labour ward into two groups, first group iatrogenic conceived twins (either ART, or medical ovulation induction mainly clomiphene citrate and gonadotrophins).The second group is a twin pregnancy who conceived naturally .

Demographic characters, maternal and neonatal outcomes were compared in both groups