Pregnancy outcomes of Chinese women undergoing IVF with embryonic cryopreservation as compared to natural conception

Abstract

Background To examine differences in the maternal characteristics and pregnancy outcomes of Chinese women with various causes of infertility who underwent in vitro fertilization (IVF) with embryonic cryopreservation treatment. Methods Cases were pregnancies after IVF-ET with embryonic cryopreservation; controls were spontaneously conceived pregnancies. Subgroup analysis was carried out according to etiology of infertility. The IVF treatment group was divided into 5 subgroups according to infertility etiology as follows: ovulation disorder, tubal disease, male infertility, endometriosis, and mixed infertility. Data on demographic characteristics, medical history, laboratory tests, and delivery were reviewed. Logistic regression analysis was performed for pregnancy and perinatal complications and neonatal outcomes. The multivariable model was adjusted for potential confounders. Results Among singleton pregnancies, compared with spontaneous pregnancies, IVF pregnancies were associated with significant increases in the rates of the following: gestational diabetes mellitus (GDM) (aOR 1.76[95% CI 1.33–2.33]), preeclampsia (2.60[1.61–4.20]), preterm preeclampsia (4.52[2.03–10.06]), postpartum hemorrhage (1.57[1.04–2.36]), intrahepatic cholestasis of pregnancy (3.84[1.06–13.94]), preterm premature rupture of membranes (2.11[1.17–3.81]), preterm birth (1.95[CI 1.26–3.01]), low birthweight (1.90[1.13–3.20]), macrosomia (1.53[1.03–2.27]), and neonatal intensive care unit (NICU) admission (1.69[1.22–2.34]) in the ovulation disorder group; GDM (1.50[1.21–1.86]), placenta previa (2.70[1.59–4.59]), placenta accreta (1.78[1.10–2.89]), postpartum hemorrhage (1.61[1.19–2.18]), macrosomia (1.60[1.21–2.13]) and 5-min Apgar score ≤ 7 (4.09[1.04–16.08]) in the tubal disease group; placenta previa (9.33[4.22–20.62]), small for gestational age (2.29[1.04–5.08]), macrosomia (2.00[1.02–3.95]) and NICU admission (2.35[1.35–4.09]) in the endometriosis group; placenta previa (4.14[2.23–7.68]) and placenta accreta (2.05[1.08–3.87]) in the male infertility group; and GDM (1.85[1.15–2.98]), placenta previa (4.73[1.83–12.21]), placental abruption (3.39[1.20–9.56]), chorioamnionitis (2.93[1.04–8.26]), preterm birth (2.69[1.41–5.15]), and 1-min Apgar score ≤ 7 (4.68[1.62–13.51]) in the mixed infertility group. Among multiple pregnancies, most of the differences that were significant in singleton pregnancies were less extensive or had disappeared. Conclusions Infertility etiology within the IVF population was found to affect maternal and neonatal outcomes among all births. During the perinatal period, infertility etiology appears to be an additional risk factor for abnormal pregnancy outcomes besides the use of IVF techniques compared with spontaneous pregnancies. Higher risk was found for ovulation disorders, and lower risk was found for male infertility.

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%) [ …”

“…We identified four comparator studies with moderate quality that examined the effect of endometriosis on the prevalence of PASD ( Table 2 ) [ 27 , 47 , 63 , 64 ]. Of those four studies, one was a population-based study and three were retrospective studies.…”

Congenital Hypothyroidism Can Dictate the Mode of Delivery and Intra-Labor Medication Usage

“…The evolution of environmental, social, and medical influences may have diverse effects on the mother-infant dyad. The past decade has witnessed an increase in the utilization of obstetric interventions, such as assisted reproduction therapy 8 , the number of medications administered during pregnancy and labor, and a rise in the rates of caesarean sections 9 .…”