Assisted reproductive technology or infertility: What underlies adverse outcomes? Lessons from the Massachusetts Outcome Study of Assisted Reproductive Technology

Stern, Judy E.; Farland, Leslie V.; Hwang, Sung Kwan; Dukhovny, Dmitry; Coddington, Charles C.; Cabral, Howard; Missmer, Stacey A.; Declercq, Eugene; Diop, Hafsatou

doi:10.1016/j.xfnr.2022.06.003

Cited by 4 publications

(3 citation statements)

References 119 publications

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“…All singleton births to subfertile women (treated and untreated) were at increased risk of low birth weight and preterm birth with the greatest risks apparent for ART births, while only ART and untreated subfertile births were at increased risk of perinatal death. Similar risk patterns across conception groups have been described in the US MOSART cohort and the Canadian study of preterm birth by Wang et al [ 9 , 10 ]. For example, Wang et al .…”

Section: Discussionsupporting

confidence: 78%

“…Stern et al . [ 10 ] propose that abnormal placentation contributes to the greater risks of preterm birth and low birth weight associated with ART treatment. The aetiology of many placental disorders is still unknown, although placenta praevia (increased threefold in ART singleton births in this study) is thought to occur largely because of damage to the endometrium caused by surgeries (prior caesarean delivery) or prior miscarriages.…”

Section: Discussionmentioning

confidence: 99%

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Ovulation induction and subfertile untreated conception groups offer improved options for interpreting risks associated with ART

Hansen,

Hart,

Milne

et al. 2024

J Assist Reprod Genet

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Purpose To identify and characterise appropriate comparison groups for population studies of health outcomes in ART-conceived births: ovulation induction (OI), subfertile untreated and fertile natural conceptions. Our secondary objective was to examine whether known risks of pregnancy complications and adverse birth outcomes in ART births are elevated in comparison with subfertile (untreated and OI) conception groups. Methods We linked State and Commonwealth datasets to identify all live and stillbirths (≥ 20 weeks) in Western Australia from 2003 to 2014 by method of conception. Demographic characteristics, maternal pre-existing conditions, adverse obstetric history and pregnancy complications were compared across conception groups. Generalised estimating equations were used to estimate adjusted risk ratios (aRRs) and 95% confidence intervals (CI) for pregnancy complications and birth outcomes in singletons. Results We identified 9456 ART, 3870 OI, 11,484 subfertile untreated and 303,921 fertile naturally conceived deliveries. OI and subfertile untreated groups more closely resembled the ART group than the fertile group; however, some differences remained across parity, maternal age, pre-existing conditions and obstetric history. In multivariate analyses, ART singletons had greater risks of placental problems (e.g. placenta praevia aRR 2.42 (95% CI 1.82–3.20)) and adverse birth outcomes (e.g. preterm birth aRR 1.38 (95% CI 1.25–1.52)) than the subfertile untreated group, while OI singletons were more similar to the subfertile group with higher risk of preeclampsia and gestational diabetes. Conclusion OI and subfertile untreated conception groups offer improved options for interpreting health outcomes in ART births. Pregnancy complications (particularly placental disorders) and adverse outcomes at delivery are more common following ART.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Ovulation induction and subfertile untreated conception groups offer improved options for interpreting risks associated with ART

Hansen,

Hart,

Milne

et al. 2024

J Assist Reprod Genet

View full text Add to dashboard Cite

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“…In couples with azoospermia, in vitro fertilization and intracytoplasmic sperm injection procedures are performed with sperm obtained by means of surgical testicular retrieval [23,24]. Several studies have shown that preeclampsia is greatly increased in pregnancies resulting from these cases [25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Association between Serum 8-Iso-Prostaglandin F2α as an Oxidative Stress Marker and Immunological Markers in a Cohort of Preeclampsia Patients

Boldeanu,

Văduva,

Caragea

et al. 2023

Life

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Background: We aimed to analyze the presence and clinical use of serum 8-iso-prostaglandin F2-alpha (8-iso-PGF2α) as an oxidative stress marker and some inflammatory status biomarkers (tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), IL-10, high-sensitivity C-reactive protein (hs-CRP), and pentraxin-3 (PTX3)) for patients with preeclampsia (PE). Methods: Sixty pregnant women, including thirty diagnosed with PE and thirty who were healthy (NP), were included in this study. For the assessment of serum levels of biomarkers, we used the Enzyme-Linked Immunosorbent Assay (ELISA) technique. Results: Our preliminary study showed that the expression level of serum 8-iso-PGF2α in the PE group was higher than in the PE after delivery (PE-AD) group (742.00 vs. 324.00 pg/mL, p < 0.0001). Groups of preeclamptic patients (PE + PE-AD) expressed significantly elevated levels for all of the assessed inflammatory mediators as compared to NP. Significant strong positive correlations with 8-iso-PGF2α levels were found for systolic blood pressure (SBP), and TNF-α (Spearman’s rho = 0.622, p-value = 0.020 and rho = 0.645, p-value = 0.002, respectively). Our study demonstrates that 8-iso-PGF2α and PTX3 have the greatest diagnostic value for pregnant women with PE. Conclusions: 8-iso-PGF2α and PTX3 can be used as independent predictor factors, along with already-known cytokines, that could represent a prophylactic way to help clinicians identify or predict which pregnant women will develop PE.

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The risk of perinatal and cardiometabolic complications in pregnancies conceived by medically assisted reproduction

Vilda,

Sutton,

Kothamasu

et al. 2024

J Assist Reprod Genet

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Purpose To examine the impact of medically assisted fertility treatments on the risk of developing perinatal and cardiometabolic complications during pregnancy and in-hospital deliveries. Methods We conducted a retrospective cohort study using medical health records of deliveries occurring in 2016–2022 at a women’s specialty hospital in a southern state of the Unites States (US). Pregnancies achieved using medically assisted reproductive (MAR) techniques were compared with unassisted pregnancies using propensity score matching (PSM), based on demographic, preexisting health, and reproductive factors. Study outcomes included cesarean delivery, gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), delivery complications, and postpartum readmission. We used Poisson regression with robust standard errors to generate risk ratios (RRs) and 95% confidence intervals (CIs) for all study outcomes. Results Among 57,354 deliveries, 586 (1.02%) pregnancies were achieved using MAR and 56,768 (98.98%) were unassisted (“non-MAR”). Compared to the non-MAR group, MAR pregnancies had significantly higher prevalence of all study outcomes, including GDM (15.9% vs. 11.2%, p < 0.001), HDP (28.2% vs. 21.1%, p < 0.001), cesarean delivery (56.1% vs. 34.6%, p < 0.001), delivery complications (10.9% vs. 6.8%, p = 0.03), and postpartum readmission (4.3% vs. 2.7%, p = 0.02). In a PSM sample of 584 MAR and 1,727 unassisted pregnancies, MAR was associated with an increased risk of cesarean delivery (RR = 1.11, 95% CI = 1.01–1.22); whereas IVF was associated with an increased risk of cesarean delivery (RR = 1.15, 95% CI = 1.03–1.28) and delivery complications (RR = 1.44, 95% CI = 1.04–2.01). Conclusions Women who conceived with MAR were at increased risk of cesarean deliveries, and those who conceived with IVF were additionally at risk of delivery complications.

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Assisted reproductive technology or infertility: What underlies adverse outcomes? Lessons from the Massachusetts Outcome Study of Assisted Reproductive Technology

Cited by 4 publications

References 119 publications

Ovulation induction and subfertile untreated conception groups offer improved options for interpreting risks associated with ART

Ovulation induction and subfertile untreated conception groups offer improved options for interpreting risks associated with ART

Association between Serum 8-Iso-Prostaglandin F2α as an Oxidative Stress Marker and Immunological Markers in a Cohort of Preeclampsia Patients

The risk of perinatal and cardiometabolic complications in pregnancies conceived by medically assisted reproduction

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