Risk of adverse pregnancy and perinatal outcomes after high technology infertility treatment: a comprehensive systematic review

Abstract

In the literature, there is growing evidence that subfertile patients who conceived after infertility treatments have an increased risk of pregnancy and perinatal complications and this is particularly true for patients who conceived through use of high technology infertility treatments. Moreover, high technology infertility treatments include many concomitant clinical and biological risk factors. This review aims to summarize in a systematic fashion the current evidence regarding the relative effect of the different procedures for high technology infertility treatments on the risk of adverse pregnancy and perinatal outcome. A literature search up to August 2016 was performed in IBSS, SocINDEX, Institute for Scientific Information, PubMed, Web of Science and Google Scholar and an evidence-based hierarchy was used to determine which articles to include and analyze. Data on prepregnancy maternal factors, low technology interventions, specific procedures for male factor, ovarian tissue/ovary and uterus transplantation, and chromosomal abnormalities and malformations of the offspring were excluded. The available evidences were analyzed assessing the level and the quality of evidence according to the Oxford Centre for Evidence-Based Medicine guidelines and the Grading of Recommendations Assessment, Development, and Evaluation system, respectively. Current review highlights that every single procedure of high technology infertility treatments can play a crucial role in increasing the risk of pregnancy and perinatal complications. Due to the suboptimal level and quality of the current evidence, further well-designed studies are needed.

Endometriosis and adenomyosis are associated with increased risk of preterm delivery and a small‐for‐gestational‐age child: a systematic review and meta‐analysis

“…Conception by ART also increases the risk of SGA and preterm delivery (44). Glavind et al (10) therefore stratified their birth cohort data according to use of ART, but their findings of an increased risk of both pregnancy complications in endometriosis patients remained essentially the same.…”

Should obese women's access to assisted fertility treatment be limited? A scientific and ethical analysis

“…As such, we would suggest that the RANZCOG statement makes reference to the metabolic health of obese women, not merely their BMI, when deciding on delaying access to ART. Furthermore, since both infertility and IVF are known risk factors for congenital abnormalities and adverse perinatal outcomes irrespective of maternal BMI, one can also argue that only prohibiting obese women from accessing IVF is both discriminatory and unfair.…”

Supraphysiological estradiol level in ovarian stimulation cycles affects the birthweight of neonates conceived through subsequent frozen‐thawed cycles: a retrospective study

“…The degree of ovarian stimulation, as measured by the number of oocytes retrieved, is positively associated with live birth rate after IVF treatment, 1 but the supraphysiological estradiol associated with multiple follicle growth may also contribute to adverse maternal and offspring outcomes, including ovarian hyper-stimulation syndrome (OHSS), preterm birth and low birthweight (LBW). 2,3 The risks of LBW are drawing increased attention. Recent studies highlighted that the elevated estradiol level on the day of triggering dramatically increased the incidence of LBW in offspring, [4][5][6] suggesting a potentially adverse effect on long-term health outcomes.…”