The effect of early fetal losses on twin assisted-conception pregnancy outcomes

Luke, Barbara; Brown, Morton B.; Grainger, David A.; Stern, Judy E.; Klein, Nathan; Cedars, Marcelle I.

doi:10.1016/j.fertnstert.2008.07.020

Cited by 45 publications

(11 citation statements)

References 54 publications

(59 reference statements)

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“…The effect of fetal loss confirms results from prior reports in both singletons (11) and twins (12) of a progressively increased adverse effect of higher plurality at six-weeks’ gestation than at birth. Other studies have demonstrated that when the fetal loss occurs later in gestation, the surviving child is at greater risk for severe neurodevelopmental consequences, including cerebral palsy (38–40).…”

Section: Discussionsupporting

confidence: 88%

“…It is unknown whether these decrements are due to parental characteristics or aspects of the ART treatment: this remains a primary challenge to infertility research (6–8). In particular, the effect of number of embryos transferred and plurality at conception versus plurality at birth needs further evaluation (9–12). In addition, an acknowledged drawback of prior ART research in the US has been the self-reported nature of the outcomes data, which is typically reported by the patient herself or by her obstetrical provider.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Adverse pregnancy outcomes after in vitro fertilization: effect of number of embryos transferred and plurality at conception

Luke

Stern

Kotelchuck

et al. 2015

Fertility and Sterility

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Objective To evaluate risks for adverse pregnancy outcomes by number of embryos transferred (ET) and fetal heart beats (FHB) in ART conceived singleton live births. Design Longitudinal cohort using cycles reported to the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System between 2004 and 2008 among women who were treated and gave birth in Massachusetts. Setting Clinic-based data. Patients ART data on 6,073 births between 2004 and 2008 were linked to vital records and hospital data. Likelihood of ET ≥3 vs 1–2, FHB >1 vs 1, and risks of preterm birth (PTB, <37 weeks gestation), low birthweight (LBW, <2,500g), and small-for-gestational age birthweight (SGA, <10th%ile) with FHB >1 were modeled with binary logistic regression using a backward-stepping algorithm, and presented as adjusted odds ratios (AORs) and 95% confidence intervals. Interventions None Main Outcome Measures ET≥3, FHB >1, PTB, LBW, and SGA. Results Higher ET was significantly more likely with older maternal age, intracytoplasmic sperm injection, assisted hatching, cleavage-stage embryos, and thawed embryos. The likelihood of FHB>1 with ≥3 ET vs 1–2 ET was 2.04 (1.68–2.48). Risks of PTB and LBW with FHB>1 were 1.63 (1.27–2.09) and 1.81 (1.36– 2.39), respectively; the risk of SGA was not significant. Nulliparity was associated with higher risks of PTB (1.34, 1.12–1.59), LBW (1.48, 1.20–1.83), and SGA (2.17, 1.69–2.78). Conclusions Number of ETs were strongly associated with FHBs, with twice the risk of FHB>1 with ≥3 ET versus 1–2 ET. Increasing FHBs were associated with significantly greater risks for PTB and LBW outcomes.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Adverse pregnancy outcomes after in vitro fertilization: effect of number of embryos transferred and plurality at conception

Luke

Stern

Kotelchuck

et al. 2015

Fertility and Sterility

Self Cite

View full text Add to dashboard Cite

show abstract

“…The effect of fetal loss reflects prior reports in both singletons (36) and twins (37) of a progressively increased adverse effect of higher plurality at six-weeks’ gestation than at birth. Other studies have demonstrated that when the fetal loss occurs later in gestation, the surviving child is at greater risk for severe neurodevelopmental consequences, including cerebral palsy (38–40).…”

Section: Discussionsupporting

confidence: 78%

Birth outcomes by infertility treatment: analyses of the massachusetts outcomes study of assisted reproductive technologies (MOSART)

Luke

Stern

Kotelchuck

et al. 2014

Fertility and Sterility

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“…In addition to our primary exposure of fresh as compared to frozen embryo transfer, the impact of other factors that have been demonstrated to be associated with adverse outcome were investigated, including: patient age at time of embryo transfer, prior parity, infertility diagnosis, number of embryos transferred, number of prior ART cycles, calendar year of treatment (2004,2005,2006), history of miscarriage and reduction in number of fetal hearts seen on initial ultrasound and number of infants born (i.e. vanishing twin) (18, 19). The adverse outcome of LBW was also stratified by preterm delivery.…”

Section: Methodsmentioning

confidence: 99%

Ovarian Stimulation and Low Birth Weight in Newborns Conceived Through In Vitro Fertilization

Kalra

Ratcliffe

Coutifaris³

et al. 2011

Obstetrics & Gynecology

176

139

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Objective Singleton infants born after in-vitro fertilization (IVF) are at increased risk for low birth weight (LBW) and/or preterm delivery. We sought to assess if the alteration of the peri-implantation maternal environment due to ovarian stimulation may contribute to increased risk in in vitro fertilization (IVF) births. Methods The Society of Assisted Reproductive Technology database was used to identify IVF-conceived infants born in the United States between 2004-2006. Associations were assessed in infants born after fresh compared with frozen and thawed embryo transfer in women of similar ovarian responsiveness, in paired analysis of infants born to the same woman following both types of embryo transfer, and in infants born following oocyte donation. Results Of 56,792 infants identified, 38,626 and 18,166 were conceived following transfer of fresh and frozen embryos, respectively. In singletons, there was no difference in preterm delivery. However, the odds of overall low birth weight (LBW) (10% vs.7.2%; AOR 1.35, 95% CI 1.20-1.51), LBW at term (2.5% vs. 1.2%; AOR 1.73, 95% CI 1.31-2.29), and preterm LBW (34.1% vs. 23.8%; AOR 1.49, 95% CI 1.24-1.78) were all significantly higher following fresh embryo transfer. In singletons following either fresh or frozen embryo transfer in the same patient, this association was even stronger (LBW: [11.5% vs. 5.6%; AOR 4.66, 95% CI 1.18 – 18.38,). In oocyte donor recipients who do not undergo any ovarian hormonal stimulation for either a fresh or a frozen embryo transfer, no difference in LBW was demonstrated (11.5% vs.11.3%; AOR 0.99, 95% CI 0.82 – 1.18). Conclusions The ovarian stimulation-induced maternal environment appears to represent an independent mediator contributing to the risk of LBW, but not preterm delivery, in infants conceived following IVF.

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The effect of early fetal losses on twin assisted-conception pregnancy outcomes

Cited by 45 publications

References 54 publications

Adverse pregnancy outcomes after in vitro fertilization: effect of number of embryos transferred and plurality at conception

Adverse pregnancy outcomes after in vitro fertilization: effect of number of embryos transferred and plurality at conception

Birth outcomes by infertility treatment: analyses of the massachusetts outcomes study of assisted reproductive technologies (MOSART)

Ovarian Stimulation and Low Birth Weight in Newborns Conceived Through In Vitro Fertilization

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