Maternal and perinatal outcome following assisted reproductive technology in a tertiary care centre: a retrospective study

Abstract

Background: Infertility is a major issue and a source of social and psychological suffering for many couples. Introduction of assisted reproductive technology (ART) leads to great relief for couples nowadays.Methods: Present study was a retrospective study conducted at K.E.M hospital, a major tertiary care hospital after approval of the institutional ethics committee. A retrospective analysis of maternal and perinatal outcome of 30 cases of ART conception from the year 2014 to 2018 was done.Results: The mean age of women enrolled into present study was 37.6 years and most common age group was 30-50 years. The main cause of infertility was unexplained (40%), other causes were female factor (33.33%), male factor (16.67%) and combined (10%). 63.33% pregnancies were singleton and 36.67% twin gestations. The most common complication seen was preterm labour (43.33%). The other complications were preeclampsia/eclampsia (33.33%), gestational hypertension, renal failure, gestational diabetes, cardiomyopathy, hepatic failure, HELLP syndrome and DIC. 60% patients had caesarean section and 40% had vaginal delivery.90.24% neonates had 5-minute Apgar score of more than or equal to 7 and 9.76% had score less than 7. There were 4 stillbirths accounting for 9.76% and out of live births,75.68% babies required NICU admission. There were 5 neonatal deaths (12.2%) and perinatal death rate was 21.95%.Conclusions: ART is associated with a variety of maternal and perinatal complications. Couples should therefore be counseled about these risks while offering them ART as a mode of conception.

Neonatal outcomes from in vitro fertilization-conceived pregnancies

“…However, for comparison, in their IVF group, significantly fewer neonates were in good condition based on the Apgar score at the fifth minute compared to non-IVF newborns (score 8-10: 325/334 vs. 304/305, respectively; P=0.023).27 Another retrospective study also found that 90.24% of neonates showed an Apgar score ≥7 at 5 minutes after birth. 28 The Apgar score at the fifth minute after birth and the change between the first and fifth minutes are useful references for assessing resuscitation response. If at the age of the fifth minute, the Apgar score can reach or more than seven, then peripartum hypoxia or ischemia is less likely to cause neonatal encephalopathy.…”

“…18 Also, a study from India reported that 75.6% of infants born to IVFconceived pregnancies required treatment in NICU, with indications of prematurity and low birth weight. 28 A study observed preterm neonates in the NICU and compared IVF and non-IVF groups revealed that gestational age and birth weight were significantly lower in IVF group, while multiple births, cesarean section, and antenatal steroid administration were significantly higher. 7 However, the IVF group showed increased preterm delivery, but not preterm mortality, whereas preterm morbidity other than IVH did not differ in the two groups.…”

“…7 Neonatal mortality of IVF infants in our study was 7.9% of NICU-treated subjects, while other studies reported 6.2%7 and 17.8%. 28 A limitation of our study was not comparing infants from natural and IVF conceptions during the same observation period, so we could not analyze whether infants from IVF had worse outcomes than non-IVF infants. In addition, other maternal factors such as infertility, socioeconomic status, and education were not analyzed.…”

Perinatal Outcome Following Assisted Reproductive Technology Treatment at A Tertiary Fertility Center In Nepal.

“…where 63.3 % women had singleton pregnancy and 36.67% had twin pregnancy. 11 In another study by Narayan et. al among 504 live born infants, almost half were twins i.e.…”