Obstetric and perinatal outcome of 1655 ICSI and 3974 IVF singleton and 1102 ICSI and 2901 IVF twin births: a comparative analysis

Abstract

A total of 3974 IVF and 1655 ICSI singleton births and 2901 IVF and 1102 ICSI twin births were evaluated. Pregnancies after both fresh and frozen transfers were included. IVF and ICSI singleton pregnancies were very similar for most obstetric and perinatal variables. The only significant difference was a higher risk for prematurity (< 37 weeks of amenorrhoea) in IVF pregnancies compared with ICSI pregnancies (12.4 versus 9.2%, OR = 1.39, 95% CI = 1.15-1.70). For twin pregnancies, differences were not statistically different except for a higher incidence of stillbirths in the ICSI group (2.08 versus 1.03%, OR = 2.04, 95% CI = 1.14-3.64). Intrauterine growth retardation with or without pregnancy-induced hypertension was observed more often in the ICSI group. Regression analysis of the data with correction for parity and female age showed similar results for twins. For singletons, this analysis showed similar results with the exception of low birth weight babies (< 2500 g), which were also observed more often in IVF pregnancies (9.6 versus 7.9%, OR = 0.79, CI = 0.65-0.98, P = 0.03). This large case-comparative retrospective analysis showed that the obstetric outcome and perinatal health of IVF and ICSI pregnancies is comparable.

Does subfertility explain the risk of poor perinatal outcome after IVF and ovarian hyperstimulation?

“…Olivennes et al (1993) found no difference in the prevalence of (very) preterm birth and (very) low birthweight among 162 IVF and 263 COHS singletons, and Bonduelle et al (2002) also showed no differences among 1499 ICSI and 1556 IVF singletons. However, the analysis of Ombelet et al (2005) showed only a significantly higher risk of preterm birth among 3974 IVF singletons relative to 1655 ICSI singletons. The authors hypothesized that the indication for ICSI is predominantly a male factor.…”

“…Part of these data has been included in the Ombelet study. An explanation for the difference has not been offered by Ombelet et al (2005). In another study (Wang et al, 2002), preterm birth was significantly more often observed in the high-technology group [IVF, ICSI and gamete intra-Fallopian transfer (GIFT)] than in the low-technology group (IUI, donor insemination), with ORs of 2.39 and 1.50, respectively, compared with naturally conceived controls.…”

“…Unfortunately, in our study, we were not able to test the hypothesis that COHS before embryo transfer affects uterine receptivity due to the small number of patients in this database. As female-factor subfertility increased the likelihood of preterm birth and low birthweight significantly more than male-factor subfertility, Wang et al (2005) suggested that uterine receptivity might offer us a biological plausibility for the phenomenon; however, no difference in the prevalence of preterm birth and low birthweight was seen among singletons born after ICSI, which is possibly more likely to be used for male factor subfertility (Bonduelle et al, 2002;Ombelet et al, 2005). If ovarian stimulation by itself has a negative effect on the pregnancy outcome, it may influence oocyte/embryo quality, resulting in impaired implantation and embryonic/fetal development (Rao, 2001).…”

Advances and Controversies in Assisted Reproductive Technology

“…137 When the perinatal and obstetrical variables are compared between ICSI and IVF, the results are very similar. 138 With respect to birth defects, Hansen et al 139 reported in 2002 that 9% of IVF babies had a birth defect versus 4.2% of non-IVF babies. The DOI:10.1002/MSJ odds ratio was 2.2 for both IVF and ICSI singletons.…”

Markers of Transmembrane and Energy Exchange in Cells of Terminal Placental Villi in Spontaneous and Induced Pregnancy

“…At the same time, the safety and possible complications of ART are still an open question. According to published reports, gestation abnormalities even in singleton induced pregnancy are more often detected than in spontaneous pregnancy [6][7][8]. Unfortunately, the structural and functional peculiarities of the placenta after ART are poorly studied.…”