Risk of severe maternal morbidity associated with in vitro fertilisation: a population‐based study

Ray, Camille Le; Pelage, L.; Seco, Aurélien; Bouvier-Colle, M.-H.; Chantry, AA; Deneux‐Tharaux, Catherine; Langer, Bruno; Dupont, C.; Rudigoz, R.-C.; Vendittelli, Françoise; Beucher, G.; Rozenberg, Patrick; Carbillon, Lionel; Azria, Élie; Baunot, Nathalie; Crenn‐Hebert, Catherine; Kayem, Gilles; Fresson, Jeanne; Mignon, Alexandre; Touzet, Sandrine; Bonnet, Marie‐Pierre; Chiesa‐Dubruille, Coralie

doi:10.1111/1471-0528.15668

Cited by 19 publications

(4 citation statements)

References 37 publications

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“…Currently, ART does not appear in French and international guidelines 32,33 among the medical conditions indicating an increased risk of major PPH, suggesting that delivery should be planned in an obstetric unit equipped to manage major PPH. Our results, which are in line with previous studies, 9,34 suggest that these recommendations could be updated. The proportion of major PPH for frozen‐IVF multiple pregnancies was 11%, which means that one in ten multiple pregnancies conceived by frozen‐IVF may be affected by major PPH.…”

Section: Discussionsupporting

confidence: 93%

Major postpartum haemorrhage after frozen embryo transfer: A population‐based study

Al‐Khatib,

Sagot,

Cottenet

et al. 2023

BJOG

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ObjectiveTo investigate the effect on major postpartum haemorrhage (PPH) of mode of conception, differentiating between naturally conceived pregnancies, fresh embryo in vitro fertilisation (fresh‐IVF) and frozen embryo transfer (frozen‐IVF).DesignRetrospective cohort study.SettingThe French Burgundy Perinatal Network database, including all deliveries from 2006 to 2020, was linked to the regional blood centre database.Population or sampleIn all, 244 336 women were included, of whom 240 259 (98.3%) were singleton pregnancies.MethodsThe main analyses were conducted in singleton pregnancies, including 237 608 naturally conceived, 1773 fresh‐IVF and 878 frozen‐IVF pregnancies. Multivariate logistic regression models adjusted on maternal age, body mass index, smoking, parity, induction of labour, hypertensive disorders, diabetes, placenta praevia and/or accreta, history of caesarean section, mode of delivery, birthweight, birth place and year of delivery, were used.Main outcome measuresMajor PPH was defined as PPH requiring blood transfusion and/or emergency surgery and/or interventional radiology.ResultsThe prevalence of major PPH was 0.74% (n = 1749) in naturally conceived pregnancies, 1.92% (n = 34) in fresh‐IVF pregnancies, and 3.30% (n = 29) in frozen‐IVF pregnancies. The risk of major PPH was higher in frozen‐IVF pregnancies than in both naturally conceived pregnancies (adjusted odds ratio [aOR] 2.63, 95% CI 1.68–4.10) and fresh‐IVF pregnancies (aOR 2.78, 95% CI 1.44–5.35).ConclusionsWe found that frozen‐IVF pregnancies have a higher risk of major PPH and they should be subject to increased vigilance in the delivery room.

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Section: Discussionsupporting

confidence: 93%

Major postpartum haemorrhage after frozen embryo transfer: A population‐based study

Al‐Khatib,

Sagot,

Cottenet

et al. 2023

BJOG

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“…It may take several cycles of IVF/ICSI to become pregnant, which can be very expensive, especially because the costs of these treatments are frequently borne by the patient [35]. As discussed, these treatments are associated with increased severe maternal morbidity (6.0% for pregnancies conceived via IVF versus 2.1% for natural conception pregnancies), and would be wasteful if the cause of infertility is due to an internal defect in the sperm [36]. Therefore, it is beneficial to know as much as possible about both female and male causes of infertility so that the couple can be best counseled.…”

Section: Current Infertility Treatments Disproportionality Burden Womenmentioning

confidence: 99%

Male Infertility is a Women’s Health Issue—Research and Clinical Evaluation of Male Infertility Is Needed

Turner

Rambhatla

Schon

et al. 2020

Cells

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Infertility is a devastating experience for both partners as they try to conceive. Historically, when a couple could not conceive, the woman has carried the stigma of infertility; however, men and women are just as likely to contribute to the couple's infertility. With the development of assisted reproductive technology (ART), the treatment burden for male and unexplained infertility has fallen mainly on women. Equalizing this burden requires reviving research on male infertility to both improve treatment options and enable natural conception. Despite many scientific efforts, infertility in men due to sperm dysfunction is mainly diagnosed by a semen analysis. The semen analysis is limited as it only examines general sperm properties such as concentration, motility, and morphology. A diagnosis of male infertility rarely includes an assessment of internal sperm components such as DNA, which is well documented to have an impact on infertility, or other components such as RNA and centrioles, which are beginning to be adopted. Assessment of these components is not typically included in current diagnostic testing because available treatments are limited. Recent research has expanded our understanding of sperm biology and suggests that these components may also contribute to the failure to achieve pregnancy. Understanding the sperm's internal components, and how they contribute to male infertility, would provide avenues for new therapies that are based on treating men directly for male infertility, which may enable less invasive treatments and even natural conception.

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“…IVF with their own gametes or donated gametes, to conceive [ 8 ]. Mothers aged 40-45 years or more can be assumed to have used donated oocytes as well as donated embryos to a greater extent, which is considered a risk factor during pregnancy and childbirth [ 9 – 13 ], but may also have an influence on the child’s health in both the long- and short-term perspectives [ 10 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Maternal advanced age, single parenthood, and ART increase the risk of child morbidity up to five years of age

et al. 2022

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Background Advanced maternal age, single status and use of assisted reproductive technology (ART) are increasing in mothers in high-income countries, and all are known risk factors for negative obstetric outcomes. Less is known about their long-term consequences for childhood morbidity. Thus, the aim of this study was to investigate morbidity up to five years of age, in the children of older, single, and/or ART-treated mothers. Methods A cross-sectional using Swedish registers was performed comprising 23 772 children. The prevalence of diagnosis and the number of hospital visits for specialist care, were compared and analyzed in relation to maternal age at childbirth, maternal civil status, and mode of conception. The odds ratio for specialized care within each ICD-chapter were estimated using single and multiple logistic regression. Results Children born to single mothers and children conceived using ART had significantly more outpatient visits for specialist care and significantly more diagnoses compared to children with married/cohabiting mothers, and spontaneously conceived children. Children born to mothers of advanced maternal age (≥40) had fewer in- and outpatient visits. However, they were significantly more often diagnosed within ICD-chapters XVI, XVII i.e., they experienced more morbidity in the neonatal period. Conclusion The results indicate that children born to single mothers and children of ART-treated mothers have a higher morbidity and consume more specialist care than children of married/cohabiting and spontaneously pregnant mothers. We conclude that the use of ART, maternal single status and advanced maternal age are risk factors of importance to consider in pediatric care and when counseling women who are considering ART treatment.

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Risk of severe maternal morbidity associated with in vitro fertilisation: a population‐based study

Cited by 19 publications

References 37 publications

Major postpartum haemorrhage after frozen embryo transfer: A population‐based study

Major postpartum haemorrhage after frozen embryo transfer: A population‐based study

Male Infertility is a Women’s Health Issue—Research and Clinical Evaluation of Male Infertility Is Needed

Maternal advanced age, single parenthood, and ART increase the risk of child morbidity up to five years of age

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