Singleton pregnancies after in vitro fertilization in Estonia: a register-based study of complications and adverse outcomes in relation to the maternal socio-demographic background

Rahu, Kaja; Allvee, Kärt; Karro, Helle; Rahu, Mati

doi:10.1186/s12884-019-2194-x

Cited by 12 publications

(15 citation statements)

References 44 publications

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“…[22,25,35,40,50] Additionally, ten studies reported on the type of caesarean section performed, either elective or emergent. [19,29,34,36,37,39,41,47,48,51] 1. IVF/ICSI versus spontaneous conception.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Eighteen studies were matched cohorts, [17,19,22,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] and sixteen unmatched cohorts. [18,20,21,[40][41][42][43][44][45][46][47][48][49][50][51][52] The quality of studies according to the NOS was moderate to high with NOS scores ranging from 4-9, of which 25 studies had scores of 8 or 9 ( Table 1). Publication bias was low as demonstrated by a funnel plot with symmetric distribution (Additional le 2, Fig.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Six studies were matched cohorts, [19,29,34,36,37,39] and two unmatched cohorts. [48,51] The quality of studies was high with NOS scores ranging from 8-9 (Table 1).…”

Section: Study Characteristicsmentioning

confidence: 99%

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Caesarean Section in Pregnancies Conceived by Assisted Reproductive Technology: A Systematic Review and Meta-analysis

Lodge-Tulloch

Elias

Pudwell

et al. 2020

Preprint

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Background: Caesarean section rates are higher among pregnancies conceived by assisted reproductive technology (ART) compared to spontaneous conceptions (SC), implying an increase in neonatal and maternal morbidity. We aimed to compare caesarean section rates in ART pregnancies versus SC, overall, by indication (elective versus emergent), and by type of ART treatment (in-vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), fresh embryo transfer, frozen embryo transfer) in a systematic review and meta‐analysis.Methods: We searched Medline, EMBASE and CINAHL databases using the OVID Platform from 1993-2019, and the search was completed in January 2020. The eligibility criteria were cohort studies with singleton conceptions after in-vitro fertilization and/or intracytoplasmic sperm injection using autologous oocytes versus spontaneous conceptions. The study quality was assessed using the Newcastle Ottawa Scale. Meta-analyses were performed using odds ratios (OR) with a 95% confidence interval (CI) using random effect models in RevMan 5.3, and I-squared (I2) test > 75% was considered as high heterogeneity.Results: 1750 studies were identified from the search of which 34 met the inclusion criteria. Compared to spontaneous conceptions, IVF/ICSI pregnancies were associated with a 1.93-fold increase of odds of caesarean section (95% CI 1.78, 2.09). When stratified by indication, IVF/ICSI pregnancies were associated with a 2.12-fold increase of odds of elective caesarean section (95% CI 1.63, 2.77) and 1.57-fold increase of odds of emergent caesarean section (95% CI 1.27, 1.95). Conclusions: The odds of delivering by caesarean section are greater for ART singleton pregnancies compared to spontaneous conceptions. Preconception and pregnancy care plans should focus on minimizing the risks that may lead to emergency caesarean sections and finding strategies to understand and decrease the rate of elective caesarean sections.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Caesarean Section in Pregnancies Conceived by Assisted Reproductive Technology: A Systematic Review and Meta-analysis

Lodge-Tulloch

Elias

Pudwell

et al. 2020

Preprint

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“…The incidence of spontaneous preterm birth is higher for ART-conceived infants when compared to spontaneous pregnancies (31.2% vs 9.7%, before 37 weeks and in spontaneous very early preterm birth before 32 weeks; 5.2 vs 1.6, respectively) and in a more recent study 10.1% vs 5.5% before 37 weeks and 3.6% vs 2.2% before 34 weeks [4][5][6].…”

Section: Introductionmentioning

confidence: 82%

The effect of early administration of rectal progesterone in IVF/ICSI twin pregnancies on the preterm birth rate: a randomized trial

Aboulghar

El-Faissal

Kamel

et al. 2020

BMC Pregnancy Childbirth

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Background: The rate of multiple pregnancies in IVF/ICSI ranges from 20 to 30%. The incidence of preterm birth in multiple pregnancies is as high as 60% and is even higher in pregnancies conceived after IVF & ICSI. The effect of progesterone on prevention of preterm birth in twins is controversial. Our group has proven a positive effect in reduction of preterm birth, by starting progesterone from the mid-trimester, in exclusively IVF/ICSI singleton pregnancies but not twins. The purpose of our current study was to explore the effect of earlier administration of natural progesterone, in IVF/ICSI twin pregnancies starting at 11-14 weeks for prevention of preterm birth. Methods: This is a double-blind, placebo controlled, single center, randomized clinical trial. Women with dichorionic twin gestations, having an IVF/ICSI trial were randomized to receive natural rectal progesterone (800 mg daily) vs placebo, starting early from 11 to 14 weeks. They also received oral and vaginal antimicrobial agents as part of our routine treatment for vaginitis and urinary tract infection. They were randomized regardless of cervical length and had no previous history of preterm birth or known Mullerian anomalies. The primary outcome was spontaneous preterm birth rate before 37 weeks. The secondary outcome was; spontaneous preterm birth before 34, 32, 28 weeks and neonatal outcome. Results: A total of 203 women were randomized to both groups, final analysis included 199 women as 4 were lost to follow up. The base line characteristics as well as gestational age at delivery were not significantly different between the study and the placebo group (34.7 ± 3.6 vs 34.5 ± 4.5, P = 0.626). Progesterone administration was not associated with a significant decrease in the spontaneous preterm birth rates before 37 weeks (73.5% vs 68%, P = 0.551), before 34 (20.6% vs 21.6%, P = 0.649), before 32 (8.8% vs 12.4%, P = 0.46) & before 28 (4.9% vs 3.1%, P = 0.555) weeks. Conclusions: Rectal natural progesterone starting from the first trimester in IVF/ICSI twin pregnancies did not reduce spontaneous preterm birth.

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“…There is also evidence that, the incidence of preterm birth is higher for ART-conceived infants when compared to spontaneous pregnancies (31.2% vs 9.7%, and in very early preterm birth 5.2 vs 1.6, respectively) & in a more recent study 10.1% vs 5.5% <37 weeks and 3.6% vs 2.2% <34 weeks. [4,5,6].…”

Section: Introductionmentioning

confidence: 99%

The effect of early administration of rectal progesterone in IVF/ICSI twin pregnancies on the preterm birth rate: A randomized trial

Aboulghar

El-Faissal

Kamel³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The rate of multiple pregnancies in IVF/ICSI ranges from 20-30% . The incidence of preterm birth in multiple pregnancies is as high as 60% and is even higher in pregnancies conceived after IVF & ICSI. The effect of progesterone on prevention of preterm birth in twins is controversial . Our group has proven a positive effect in reduction of preterm birth ,by starting progesterone from the mid-trimester ,in exclusively IVF/ICSI singleton pregnancies but not twins. The purpose of our current study was to explore the effect of earlier administration of natural progesterone, in IVF/ICSI twin pregnancies starting at 11-14 weeks for prevention of preterm birth. Methods: This is a double-blind, placebo controlled, single center, randomized clinical trial. Women with dichorionic twin gestations, following an IVF/ICSI trial were randomized to receive natural rectal progesterone (800 mg daily ) vs placebo, starting early from 11-14 weeks. They were randomized regardless of cervical length and had no previous history of preterm birth or known Mullerian anomalies. The primary outcome was, spontaneous preterm birth rate <37 weeks. The secondary Outcome was; spontaneous preterm birth <34,32,28 weeks and neonatal outcome. Results: A total of 203 women were randomized to both groups, final analysis included 199 women as 4 were lost to follow up. The base line characteristics as well as gestational age at delivery were not significantly different between the study and the placebo group (34.7±3.6 vs 34.5±4.5, P=0.626). Progesterone administration was not associated with a significant decrease in the spontaneous preterm birth rates <37 weeks (73.5% vs 68%, P = 0.551), <34 (20.6% vs 21.6%, P = 0.649), <32 (8.8% vs 12.4%, P = 0.46) & <28 (4.9 % vs 3.1 %, P = 0.555). Conclusions: Rectal natural progesterone starting from the first trimester in IVF/ICSI twin pregnancies did not reduce spontaneous preterm birth.The trial was registered on 31 January 2014 at www.ISRCTN.com, 69810120.

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Singleton pregnancies after in vitro fertilization in Estonia: a register-based study of complications and adverse outcomes in relation to the maternal socio-demographic background

Cited by 12 publications

References 44 publications

Caesarean Section in Pregnancies Conceived by Assisted Reproductive Technology: A Systematic Review and Meta-analysis

Caesarean Section in Pregnancies Conceived by Assisted Reproductive Technology: A Systematic Review and Meta-analysis

The effect of early administration of rectal progesterone in IVF/ICSI twin pregnancies on the preterm birth rate: a randomized trial

The effect of early administration of rectal progesterone in IVF/ICSI twin pregnancies on the preterm birth rate: A randomized trial

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