Background: Multifetal pregnancies are on the rise due to advanced treatment modalities for infertility and assisted reproductive techniques (ART). These pregnancies are associated with more maternal and fetal morbidities as compared to singleton gestations. Even among twin pregnancies, those conceived by ART have been shown to be associated with adverse outcomes as compared to their spontaneously conceived counterparts. Objectives: The primary objective was to examine whether DCDA twin pregnancies conceived after ART were at a higher risk of adverse outcomes as compared to their spontaneously conceived counterparts.