Obstetric and perinatal outcomes in singleton pregnancies resulting from IVF/ICSI: a systematic review and meta-analysis

Abstract

Singletons pregnancies after IVF/ICSI are associated with higher risks of obstetric and perinatal complications when compared with spontaneous conception. Further research is needed to determine which aspect of assisted reproduction technology poses most risk and how this risk can be minimized.

Assisted Reproductive Technology and Early Intervention Program Enrollment

“…Pooled ORs from systematic reviews with metaanalyses indicated an approximate twofold increase in singletons born at <37 weeks of gestation. 10 A recent review reported an OR of 1.5 (95% CI: 1.5-1.6) among singletons, 31 by guest on May 10, 2018 http://pediatrics.aappublications.org/ Downloaded from which is close to our findings (aOR: 1.45; 95% CI: 1.32-1.59). We also found that preterm birth was higher among Subfertile, but this relationship was not as strong as in the ART group (aOR: 1.18; 95% CI: 1.06-1.31).…”

The impact of ovulation induction and ovarian stimulation on the risk of pregnancy-induced hypertension and on neonatal outcomes: A case/control study

“…Although very often reported [4], we did not find any association between ovarian induction or ovarian stimulation/ ART and GDM. However, the rate of GDM was particularly high, more than 13% in all of the groups, as we already observed in our total cohort [33], and the possibly greater risk associated with PCOS/ovarian induction or stimulation/ART might have been concealed by the high rate of GDM and its risk factors in our specific population [33], some of which are also possible risk factors for infertility (age, obesity).…”

“…We showed the following: (i) PCOS per se was associated with an increased risk of PIH, (ii) ovulation induction without ART procedures was associated with an increased risk of PIH and higher caesarean sections rates; and (iii) EFW >90th percentile during the third trimester was more likely to be observed in women having had mild ovarian stimulation and ART procedure. A recent meta-analysis showed a 2.5-fold higher risk of PIH in pregnant women following IVF/ICSI, compared with spontaneous pregnancies [4]. As in our study, an increased risk has been demonstrated in pregnancies after ovulation induction vs spontaneous pregnancies, after adjustment for age, gestational age and parity [5], but this result was not found in other studies [12,15].…”

“…Pregnancies following assisted conceptions have been associated with a higher risk of hypertensive disorders of pregnancy, gestational diabetes and caesarean section [1][2][3][4][5][6] but the mechanisms underlying these associations need to be clarified [7]. Indeed, after exclusion of twin pregnancies, that carry specific over risks [1,2], the role of the underlying cause of infertility, such as a polycystic ovarian syndrome (PCOS) [8] through the hormonal environment induced by hormonal stimulation and menstrual preconditioning [9], and the role of the diverse types of ovarian stimulation and assisted reproductive technology (ART) procedures with mild or high estrogen levels [10], have been questioned.…”

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

“…Numerous studies have shown that children born from in vitro fertilization (IVF) are more likely to be born smaller and earlier, even when limited to singletons [1][2][3]. Prior studies have also consistently reported an excess of large-for-gestational age (LGA) birthweights among children born from frozen embryos; [4][5][6][7][8][9][10][11][12] longer embryo culture of fresh embryos has also been implicated as a potential cause of LGA [13].…”