Infertility, Assisted Reproductive Technology, and Adverse Pregnancy Outcomes

Abstract

The National Institute of Child Health and Human Development held a workshop on September 12-13, 2005, to summarize the risks for adverse pregnancy outcomes after assisted reproductive technology (ART), develop an approach to counseling couples regarding these risks, and establish a research agenda. Although the majority of ART children are normal, there are concerns about the increased risk for adverse pregnancy outcomes. More than 30% of ART pregnancies are twins or higher-order multiple gestations (triplets or greater) and more than one half of all ART neonates are the products of multifetal gestations, with an attendant increase in prematurity complications. Assisted reproductive technology singleton pregnancies also demonstrate increased rates of perinatal complications-small for gestational age infants, preterm delivery, and perinatal mortality-as well as maternal complications, such as preeclampsia, gestational diabetes, placenta previa, placental abruption, and cesarean delivery. Although it is not possible to separate ART-related risks from those secondary to the underlying reproductive pathology, the overall increased frequency of obstetric complications, including preterm birth and small for gestational age neonates, should be discussed with the couple. Significant gaps in knowledge were identified, and the basic science and clinical and epidemiologic research required to address these gaps is outlined.

Ivf versus spontan singleton pregnancies fetal and maternal outcomes in a tertiary care hospital

“…There are many reports in the literature that IVF pregnancies have higher adverse pregnancy outcomes, but most of them did not studied only singleton pregnancies and none of them reported maternal age adjusted complication rates [8,9]. We know that the incidence of adverse obstetric outcomes such as preeclampsia, gestational diabetes, placental abruption, placenta previa and abnormal labor have been observed with a higher ratein women with advanced ages [10,11] .That's why we have chosen maternal age and parity matched singleton pregnancies in control group.…”

Efficacy of Intra Uterine Insemination in the Treatment of Infertility

“…Despite increase in use of assisted reproductive technologies They still costy, invasive (7), IVF is associated with undesirable out comes these include preterm delivery leading to increase risk of new born prematurity and its can comitant cost and morbidity and increase rate of multiple gestation (Keddy et al, 2007).…”

Effectiveness of Prophylactic Cervical Cerclage in Prolonging Higher-Order Multiple Pregnancies

“…[1][2][3][4][5] This increase has been associated with financial and logistical problems as well as higher perinatal morbidity and mortality rates among women with higher-order multiple pregnancies in comparison to their singleton counterparts. [6][7][8][9][10] The rate of higherorder multiple pregnancies is especially high in certain countries, particularly those in the developing world where there are no legal restrictions on the number of embryos transferred at in vitro fertilisation centres.…”