Antenatal management of singleton pregnancies conceived using assisted reproductive technology

Richardson, Alison; Taylor, M. J. O.; Teoh, Joo P.; Karasu, Tülay

doi:10.1111/tog.12608

Cited by 4 publications

(2 citation statements)

References 73 publications

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“…ART is associated with an increased risk of ovarian hyperstimulation syndrome, miscarriage, ectopic pregnancy, pregnancy-induced hypertension, pre-eclampsia, venous thromboembolism (VTE), genetic and chromosomal disorders, structural abnormalities, fetal growth restriction (FGR), stillbirth and preterm labour. [7][8][9][10] These risks also increase with maternal age and multiple pregnancies.…”

Section: Assisted Reproductive Technologiesmentioning

confidence: 99%

Very advanced maternal age

Howell

Blott

2020

The Obstetric & Gynaecologis

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Increasing fertility options have led to increased birth rates among women over the age of 45 years. Most women aged 45 years or older conceive via assisted reproductive technologies, which are associated with increased risks to both mother and fetus. Multiple pregnancies are disproportionately common in this group of women as a result of multiple embryo transfer. The maternal and fetal risks are increased significantly in multiple pregnancies. A maternal age of 45 years or more is associated with complications in early pregnancy and the antenatal period and with significant obstetric complications. Fetal complications are increased in this group; in particular there is an increased risk of multiple births, increased rates of preterm birth and higher perinatal mortality rates. Learning objectivesTo understand the maternal implications, complications and risks of pregnancy in women of very advanced maternal age, to aid counselling this group of women prior to and during pregnancy. To understand the fetal complications associated with pregnancy in women of very advanced maternal age, including stillbirth and preterm labour.To establish an evidence-based approach to the antenatal management and care of women of very advanced maternal age.

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Section: Assisted Reproductive Technologiesmentioning

confidence: 99%

Very advanced maternal age

Howell

Blott

2020

The Obstetric & Gynaecologis

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“…In a climate of increasing age of conception and availability of assisted reproductive technology (ART), the number of women seeking assisted conception has grown rapidly [ 1 ]. More than eight million babies have been born via in vitro fertilisation (IVF) since the first in 1978 [ 2 ] and 1–5% of babies born in the developed world today are conceived via IVF [ 3 ]. In the UK the number of IVF cycles per year has more than tripled since 1994 (18,304 cycles) to 2018 (68,724 cycles) [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Contraception after in vitro fertilisation (IVF): a qualitative study of the views of women who have had spontaneous pregnancies after successful IVF

et al. 2022

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Background The use of in vitro fertilisation (IVF) has increased rapidly since its inception in 1978. Women seeking IVF have a wide range of subfertility causes including unexplained subfertility. A growing subgroup of women seek treatment for other reasons than fertility problems, for example, women in same sex relationships and single women. This study aims to better understand the contraceptive needs of women after successful IVF pregnancy in order to improve service delivery and prevent unplanned and rapid-repeat pregnancies. Methods A qualitative study of views of women who have had spontaneous pregnancies after successful IVF. Participants were recruited using purposive and snowballing sampling methods from social media and peer networks. The framework method was used for analysis using NVivo12. Results The sample comprised 21 interviewees from the United Kingdom (UK), having a range of spontaneous pregnancy outcomes, including single and multiple livebirths, miscarriage, ectopic pregnancy and termination of pregnancy. Contraceptive choices were subject to a complex and dynamic interaction of influencing factors including beliefs regarding subfertility, desire for children and views on contraception. None of the women recalled receiving any information or useful counselling about contraception during fertility or maternity care. After IVF pregnancy, most women (n = 16) used no or ineffective contraception. Spontaneous pregnancy was not universally welcomed in this group and inter-pregnancy intervals were often short (n = 16, less than 18 months). Even after subsequent spontaneous pregnancy, use of contraception and the most effective methods remained low. Women held persistent beliefs regarding their subfertility despite subsequent spontaneous pregnancy. They associated aspects of the IVF process with a sense of personal failure, despite an ultimately “successful” outcome of livebirth. These aspects may reinforce their self-belief in subfertility. Other barriers to contraception use in women having IVF included: lack of knowledge of likelihood of spontaneous pregnancy, lack of contraceptive experience and inherent incentives towards shorter inter-pregnancy intervals. Conclusions The contraceptive needs of women having IVF pregnancies are real and are being overlooked. Fertility services should take responsibility for providing information on the risks of subsequent spontaneous pregnancy. Maternity and community healthcare professionals must address women’s perceptions of their fertility in order to engage them in contraception counselling.

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