Association between infertility treatment and intrauterine growth: a multilevel analysis in a retrospective cohort study

Abstract

ObjectivesThis study aimed to identify intrauterine growth differences according to infertility treatment compared with spontaneous conception and to describe intrauterine growth trajectories.DesignRetrospective cohort study.SettingA single primary and tertiary medical centre in Japan.ParticipantsThis study included singleton pregnant women with prenatal check-ups and delivery at the University of Yamanashi Hospital between 1 July 2012 and 30 September 2017. Patients were divided into four groups: spontaneous conception, infertility treatment without assisted reproductive technology (ART), fresh-embryo transfer and frozen embryo transfer (FET).InterventionsDifferences in intrauterine growth according to the infertility treatment, including ART, and birth weight were evaluated. Multilevel analysis was employed to evaluate intrauterine growth trajectories stratified by the sex of the offspring.Primary outcome measureEstimated fetal weight (EFW) assessed by ultrasound examination.ResultsWe assessed data from 37 239 prenatal examination results from 2377 pregnant women (spontaneous conception, n=1764; infertility treatment without ART, n=171; fresh-embryo transfer, n=112; and FET, n=330) in the final analysis. Multilevel analysis was adjusted for gestation duration, gestation period, parity, hypertensive disorders of pregnancy, type of infertility treatment, maternal age, smoking status, placenta previa, thyroid disease, gestational diabetes mellitus and the interaction between each potential confounding factor and gestation duration. In male fetuses, the interaction between FET and gestational duration (estimate: 0.36; 95% CI: 0.06 to 0.67) significantly affected the EFW. Similarly, in female fetuses, FET (estimate: −69.85; 95% CI: −112.09 to −27.61) and the interaction between FET and gestation duration (estimate: 0.57; 95% CI: 0.28 to 0.87) significantly affected the EFW.ConclusionsThis study shows that FET affects intrauterine growth trajectory from the second trimester to term, particularly in female fetuses. Our findings require further prospective research to examine the effect of infertility treatment on fetal growth.

Placenta Accreta Spectrum Disorder Complicated with Endometriosis: Systematic Review and Meta-Analysis

“…Four studies were excluded due to the presence of overlapping cases [ 39 , 40 , 41 , 42 ]. Forty-eight studies that comprised 34,603,164 pregnancies and 59,241 pregnancies with endometriosis met the inclusion criteria for the descriptive analysis [ 26 , 27 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 ,…”

“…Supplemental Tables S1–S4 summarizes the metadata of the 48 included studies [ 26 , 27 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 ] and 4 excluded studies [ 39 , 40 ,…”

“…Fourteen of 48 studies were nationwide studies, and no study was a randomized, controlled study. Approximately one-third of the studies were performed in Europe ( n = 17; 35.4%) [ 27 , 46 , 48 , 53 , 54 , 57 , 60 , 62 , 64 , 70 , 71 , 72 , 73 , 77 , 79 , 83 , 86 ], followed by Japan ( n = 11; 22.9%) [ 26 , 52 , 55 , 56 , 58 , 59 , 68 , 74 , 81 , 82 , 88 ], China ( n = 10; 20.8%) [ 43 , 45 , 47 , 49 , 61 , 66 , 67 , 69 , 78 , 80 ], the United States ( n = 4; 8.3%) [ 50 , 51 , 75 , 87 ], Israel ( n = 2; 4.2%) [ 63 , 84 ], Australia ( n = 2; 4.2%) [ 76 , 85 ], Canada ( n = 1; 2.1%) [ …”

“…A meta-analysis using 27 comparative retrospective studies (7 of low and 20 of moderate quality) was conducted to determine the influence of ART on the prevalence of placenta previa ( Supplemental Table S2 , Table 3 ) [ 26 , 43 , 47 , 48 , 49 , 51 , 52 , 53 , 54 , 55 , 57 , 60 , 61 , 62 , 65 , 66 , 67 , 69 , 72 , 73 , 78 , 79 , 82 , 85 , 86 , 87 , 88 ]. Since considerable heterogeneity of studies was observed, a random-effects analysis was used.…”

Особливості Експресії Маркера Ендотеліальних Клітин Cd34 У Судинному Руслі Вілльозного Дерева Плаценти При Вагітності, Індукованій У Циклі Допоміжних Репродуктивних Технологій

“…Вагітність після ДРТ має більш високий ризик несприятливих акушерських ускладнень, включаючи гестаційний цукровий діабет, гестаційну гіпертензію, відшарування плаценти, передчасний розрив плодових оболонок, передчасні пологи, багатоводдя, багатопліддя, низьку масу тіла при народженні, уроджені вади розвитку, післяпологову кровотечу [5][6][7][8][9][10][11]. Зростаюча кількість доказів підтримує гіпотезу про те, що різні несприятливі наслідки вагітності, які спостерігаються після ДРТ, відбуваються через неоптимальну плацентацію, викликану аномальною функцією трофобласта [5,6,9]. Автори при цьому виявляють зміни на ультраструктурному рівні, патологічні зміни у функціях плацентарних генів, але значна увага в основному приділяється процесам імплантації та раннього ембріонального періоду [12][13][14][15][16].…”