The effect of fertility treatment on adverse perinatal outcomes in women aged at least 40 years

Harlev, Avi; Walfisch, Asnat; Oran, Eynan; Har-Vardi, Iris; Friger, Michael; Lunenfeld, Eitan; Levitas, Eliahu

doi:10.1002/ijgo.12345

Cited by 15 publications

(10 citation statements)

References 42 publications

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“…In the present retrospective cohort study, we observed the increased risks of perinatal complications and poor neonatal outcomes related to ART, such as GDM, hypertension during pregnancy, ICP, placental abruption, premature rupture of membranes, postpartum hemorrhage, polyhydramnios, premature delivery, and low birth weight. Previous studies have reported that ART has an increased incidence of hypertension during pregnancy, GDM, ICP, postpartum hemorrhage, premature delivery, and low birth weight, [13–16] which is consistent with our present results. The newest ART surveillance in USA reported 23.6% infants conceived with ART were born low birth weight and 29.9% of ART infants were preterm.…”

Section: Discussionsupporting

confidence: 93%

Perinatal complications and live-birth outcomes following assisted reproductive technology

Lei

Lan

Wang

et al. 2019

Chinese Medical Journal

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BackgroundWith the development of assisted reproductive technology (ART) and its increasing success rate in the mainland of China, more attention has been paid to the safety of ART. In this study, we explored the associations between conception by ART and pregnancy/perinatal complications, and neonatal outcomes compared with similar outcomes following spontaneous conception.MethodsThis retrospective cohort study of pregnancies over a 3-year period (2013–2015) was performed at Beijing Obstetrics and Gynecology Hospital, Beijing, China. Subjects were divided into two groups: conception by ART (n = 2256) or spontaneous conception (n = 6768). According to different fertilization modes, the ART group was divided into in vitro fertilization (IVF, n = 1873) and intracytoplasmic sperm injection (ICSI, n = 383) subgroups. The ART group was also divided into two different embryo transfer methods; fresh embryo transfer (ET, n = 1583) and frozen embryo transfer (FET, n = 673) subgroups. Pregnancy complications, perinatal complications, and neonatal outcomes of the enrolled subjects were investigated and analyzed by univariate analysis and multivariate logistic regression.ResultsAfter adjustment for maternal age, gravidity, parity, maternal education, smoking, alcohol consumption, and body mass index (BMI), pregnancies conceived by ART were associated with a significantly increased incidence of gestational diabetes mellitus (GDM; OR 1.88, 95% CI 1.56–2.27), gestational hypertension (OR 2.18, 95% CI 1.83–2.60), and intrahepatic cholestasis of pregnancy (ICP) (OR 2.79, 95% CI 2.15–3.64), compared with spontaneous conception. These associations were similar for the singleton group. In the twin group, only the incidence of ICP was significantly higher than in controls. We found that pregnancies conceived by ART were associated with perinatal complications, including placental abruption (OR 2.14, 95% CI 1.33–3.45), premature rupture of membranes (PROM; OR 1.24, 95% CI 1.06–1.45), postpartum hemorrhage (OR 2.89, 95% CI 2.33–3.59) and polyhydramnios (OR 2.01, 95% CI 1.29–3.16). The singleton group had a similar result with placental abruption, but not with fetal membranes ruptures before labor and polyhydramnios. There were no significant differences in the incidence of these perinatal complications in the twin group. Some neonatal outcomes, including preterm labor (OR 4.29, 95% CI 3.84–4.80) and low birth weight (OR 1.72, 95% CI 1.42–2.08), were more likely to occur with singleton births after ART. However, there were no significant differences for these outcomes from twin pregnancies. Perinatal complications and neonatal outcomes were consistent between the IVF and ICSI subgroups. The FET and ET subgroups showed a similar increase in complications, except for the incidence of placental abruption. After taking into account the effects of parity, birth plurality and maternal age, the ART group still exhibited increased maternal and neonatal complications, although some differences narrowed or disappeared.ConclusionsThis retro...

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Section: Discussionsupporting

confidence: 93%

Perinatal complications and live-birth outcomes following assisted reproductive technology

Lei

Lan

Wang

et al. 2019

Chinese Medical Journal

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“…Eighteen studies were matched cohorts, [17,19,22,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] and sixteen unmatched cohorts. [18,20,21,[40][41][42][43][44][45][46][47][48][49][50][51][52] The quality of studies according to the NOS was moderate to high with NOS scores ranging from 4-9, of which 25 studies had scores of 8 or 9 ( Table 1). Publication bias was low as demonstrated by a funnel plot with symmetric distribution (Additional le 2, Fig.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Eight studies were matched cohorts, [17, 19, 27-29, 32, 35, 39] and six unmatched cohorts. [20,21,43,44,46,47] The quality of studies according to the NOS was moderate to high with NOS scores ranging from 6-9 (Table 1).…”

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confidence: 99%

Caesarean Section in Pregnancies Conceived by Assisted Reproductive Technology: A Systematic Review and Meta-analysis

Lodge-Tulloch

Elias

Pudwell

et al. 2020

Preprint

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Background: Caesarean section rates are higher among pregnancies conceived by assisted reproductive technology (ART) compared to spontaneous conceptions (SC), implying an increase in neonatal and maternal morbidity. We aimed to compare caesarean section rates in ART pregnancies versus SC, overall, by indication (elective versus emergent), and by type of ART treatment (in-vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), fresh embryo transfer, frozen embryo transfer) in a systematic review and meta‐analysis.Methods: We searched Medline, EMBASE and CINAHL databases using the OVID Platform from 1993-2019, and the search was completed in January 2020. The eligibility criteria were cohort studies with singleton conceptions after in-vitro fertilization and/or intracytoplasmic sperm injection using autologous oocytes versus spontaneous conceptions. The study quality was assessed using the Newcastle Ottawa Scale. Meta-analyses were performed using odds ratios (OR) with a 95% confidence interval (CI) using random effect models in RevMan 5.3, and I-squared (I2) test > 75% was considered as high heterogeneity.Results: 1750 studies were identified from the search of which 34 met the inclusion criteria. Compared to spontaneous conceptions, IVF/ICSI pregnancies were associated with a 1.93-fold increase of odds of caesarean section (95% CI 1.78, 2.09). When stratified by indication, IVF/ICSI pregnancies were associated with a 2.12-fold increase of odds of elective caesarean section (95% CI 1.63, 2.77) and 1.57-fold increase of odds of emergent caesarean section (95% CI 1.27, 1.95). Conclusions: The odds of delivering by caesarean section are greater for ART singleton pregnancies compared to spontaneous conceptions. Preconception and pregnancy care plans should focus on minimizing the risks that may lead to emergency caesarean sections and finding strategies to understand and decrease the rate of elective caesarean sections.

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“…In 14 studies, the indication for C-section was significant in pregnancies resulting from ART when compared with spontaneous pregnancies. [8][9][10]12,15,19,22,23,25,33,34,[38][39][40] -Premature and preterm rupture of membranes:…”

Section: Complicationsmentioning

confidence: 99%

Complications in pregnancies achieved by assisted reproduction

Madrazo-Cabo¹,

León-Durán²,

Oliveros-Montiel³

et al. 2023

GMM

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Introduction: Pregnancies resulting from assisted reproductive technologies (ART) have been documented to have a higher risk of adverse effects. Objective: To provide evidence on obstetric and perinatal complications associated with conceptions by ART versus spontaneous pregnancies. Method: Comprehensive review of original articles published between 2010 and 2018 addressing the more common obstetric and perinatal complications in pregnancies resulting from in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), in comparison with spontaneous conceptions. Results: Thirty-seven original articles, which reported on 26 cohort studies and 11 case-control trials, were included. IVF and ICSI conceptions were associated with a larger number of obstetric and perinatal complications such as low birth weight, prematurity, low weight for gestational age, admission to the neonatal intensive care unit, congenital malformations, C-sectionand premature rupture of membranes, among others. Conclusions: Pregnancies by ART are associated with an increased risk of obstetric and perinatal complications in comparison with spontaneous conceptions. Further research is needed to determine which aspects result in higher risk.

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The effect of fertility treatment on adverse perinatal outcomes in women aged at least 40 years

Cited by 15 publications

References 42 publications

Perinatal complications and live-birth outcomes following assisted reproductive technology

Perinatal complications and live-birth outcomes following assisted reproductive technology

Caesarean Section in Pregnancies Conceived by Assisted Reproductive Technology: A Systematic Review and Meta-analysis

Complications in pregnancies achieved by assisted reproduction

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