Aim. To assess the main indicators of the initial reproductive health of parents, somatic health of the mother and their impact on the health of children born with singleton pregnancy ART. Materials and methods. The study included all newborn infants from singleton ART who were born at the Avicenna Medical Center (Novosibirsk) over the period 2006–2017 (n=409) and their parents (n=818). All stages of overcoming infertility (from the moment the parents go to the clinic to the birth of children) are considered in the context of one center, in a relatively homogeneous social group, with ensuring continuity at all stages. The average experience of infertility in couples was 7.2±0.2 years. The groups were formed depending on the type of infertility and the method of assisted reproductive technologies (ART) used: 205 children were born using in vitro fertilization (IVF), 204 children were born using the method of Intracytoplasm Sperm Injection (ICSI). The method of IVF and transfer of embryos into the uterine cavity is more often used in women with tuboperitoneal, endocrine types of infertility (premature ovarian failure syndrome), as well as in infertility associated with endometriosis. More serious reproductive problems (severe forms of male infertility, a combination of several types of infertility) in most cases lead to the use of more serious technological methods of ART, in particular, the addition of IVF and embryo transfer by the ICSI method. The reasons underlying infertility in most cases lead not only to the choice of the ART method, but also determine the characteristics of the course of pregnancy and the development of the intrauterine fetus. Pregnancy in the IVF group is significantly more often complicated by the threat of termination and premature birth, while ICSI pregnancy more often leads to impaired development of the intrauterine fetus. Conclusion. Features of medical support of women during the preparation for ART and, of course, during pregnancy, with a comprehensive, interdisciplinary correction of expected complications in each of the groups, will improve the perinatal outcomes of induced pregnancy and will contribute to the birth of healthy offspring.
Introduction. The use of sisted reproductive technologies has had sufficient experience to reduce the risks associated with the technologies themselves. But pediatricians remain concerned about the health of children born from induced pregnancies because of the influence of the parents’ initial health on perinatal outcomes. Congenital malformations remain socially significant, the risk of which may be higher for children from induced pregnancy.Objective: to evaluate the effect of initial parental health and the methods of assisted reproductive technology used on the formation of congenital malformations and minor anomalies in children from singleton induced pregnancies.Materials and Methods. A retrospective cohort study was conducted using data on live-born children from singleton induced pregnancy born at the Avicenna Medical Center (Novosibirsk) over the period from 2007 to 2017 (n = 409). The reproductive, somatic, and infectious history of the parents and the methods of assisted reproductive technology used were assessed. Parental fertility treatment up to childbirth was performed in the same center, which ensured complete continuity of follow-up. Differences between the groups of children from SIP with and without congenital anomalies were determined using Pearson’s chi-squared test.Results and discussion. We found that children with congenital malformations and minor anomalies were more often born as a result of subsequent pregnancies; thawed embryos transferred at the blastocyst stage were used in assisted reproductive technology programs (p < 0.05); exacerbations of herpes type 2 infection were diagnosed during the current pregnancy (p < 0.05). In the group of children with only CM, the parents had a longer history of infertility (8.3 ± 1.2) years; pregnancy was achieved by transferring fresh embryos at the blastocyst stage (in 68.2% of cases). In the group of children without congenital malformations and minor anomalies, the maternal infectious history was more severe: there were significantly more frequent cases of urogenital infections (p < 0.05) and exacerbations of herpes simplex virus type 1 during pregnancy (p < 0.05).Conclusion. A set of measures aimed at an earlier solution of the infertility problem is necessary for the primary prevention of congenital abnormalities associated with the age and duration of parental infertility.
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