Adverse pregnancy and birth outcomes by infertility diagnoses with and without ART treatment

Increased risk of large-for-gestational age birthweight in singleton siblings conceived with in vitro fertilization in frozen versus fresh cycles

“…As a result, birthweight z-scores were higher for three out of the four groups, ranging from +0. 16 for the frozen/frozen to +0.51 for the fresh/frozen group, with no difference in the frozen/fresh group.…”

“…Most often studies compare women treated with IVF to fertile women, but this approach has limitations: the two groups usually differ on a range of important characteristics such as age, socioeconomic status, and education, as well as reproductive history. Several studies have compared women treated with IVF to women with a history of subfertility and no IVF treatment [11,15,16] in an effort to quantify the contribution of the IVF treatment to adverse perinatal and infant outcomes.…”

Is the wrong question being asked in infertility research?

“…Among twins, births to both fertile and ART-treated mothers had substantially lower rates of perinatal mortality than births to mothers with subfertility indicators [26]. We also examined pregnancy and birth outcomes by several infertility-related diagnoses among women in our study cohort, with and without ART treatment, and compared them to outcomes among fertile women [14]. As shown in Table 3, most children born to women with infertility-related diagnoses experienced significantly higher risks for premature birth and low birthweight, regardless of the presence or absence of ART treatment.…”

“…Significantly increased risks included gestational diabetes, prenatal hospital admissions, and primary cesarean section (uterine factors, AOR 1.96, 95 % CI 1.15, 3.36) ( Table 4). When we examined pregnancy and birth outcomes by infertility-related diagnoses with and without ART treatment, and compared them to outcomes among fertile women, most women with infertility-related diagnoses experienced significantly higher risks for pregnancy hypertension, gestational diabetes, and prenatal admissions ( [14]; Table 5). We also compared postpartum rehospitalization rates among subfertile women with and without ART treatment and fertile women [28].…”

“…As part of these studies, we created a subfertility measure through a combination of information from birth certificate checkboxes, diagnosis codes of infertility during hospitalizations and prior use of ART which allowed for identification of women with indicators of subfertility who did not receive ART treatment for the index delivery [12]. Other of our studies compared outcomes resulting from specific diagnoses that might contribute to subfertility [13,14]. The addition of these comparison groups has, in the course of multiple analyses, changed our perspective from an original focus on ART treatment as the primary cause of excess morbidity to one centered instead on the underlying infertility-related diagnoses.…”