Assisted reproductive technology and pregnancy outcome

Area of Science:

• Reproductive Medicine
• Maternal-Fetal Medicine
• Genetics

Background:

• Assisted reproductive technology (ART) encompasses various treatments to achieve pregnancy.
• Concerns exist regarding potential risks associated with ART, including chromosomal abnormalities and adverse pregnancy outcomes.
• Understanding these risks is crucial for patient counseling and clinical management.

Purpose of the Study:

• To investigate the association between ART use and chromosomal abnormalities, fetal malformations, and adverse pregnancy outcomes.
• To compare risks between different ART methods (ovulation induction vs. in vitro fertilization) and spontaneous conception.

Main Methods:

• Prospective analysis of singleton pregnancies from the First And Second Trimester Evaluation of Risk (FASTER) trial.
• Categorization of pregnancies into: no ART, ovulation induction (with or without intrauterine insemination), and in vitro fertilization (IVF).
• Multivariate logistic regression analysis adjusted for multiple confounding factors.

Main Results:

• No increased incidence of fetal chromosomal or structural abnormalities was found with any ART method.
• Ovulation induction was associated with increased risks of placental abruption, late fetal loss, and gestational diabetes.
• In vitro fertilization (IVF) was linked to higher rates of preeclampsia, gestational hypertension, placental abruption, placenta previa, and cesarean delivery.

Conclusions:

• While ART does not elevate fetal chromosomal or structural abnormality rates, specific methods carry distinct risks.
• In vitro fertilization (IVF) is associated with a significant increase in several adverse pregnancy outcomes.
• Ovulation induction also presents some increased risks, though generally fewer than IVF.