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IVF and stillbirth: a prospective follow-up study
K Wisborg1, H J Ingerslev, T B Henriksen
1Department of Paediatrics, Perinatal Epidemiology Research Unit, Aarhus University Hospital, Brendstrugaardsvej 100, Skejby, DK-8200 Aarhus, Denmark.
Human Reproduction (Oxford, England)
|February 25, 2010
Summary
Women undergoing in vitro fertilization (IVF) have a significantly higher risk of stillbirth compared to fertile women. This increased risk associated with IVF/ICSI persists even after accounting for various maternal factors, suggesting a link to the treatment itself.
Area of Science:
- Reproductive Medicine
- Perinatal Epidemiology
- Obstetrics
Background:
- Previous studies suggest an elevated stillbirth risk in pregnancies conceived via assisted reproduction technology (ART).
- The specific contribution of fertility treatments versus underlying subfertility to this risk remains unclear.
- This study investigates stillbirth risk across different conception methods, including IVF/ICSI, non-IVF ART, subfertility, and fertile conception.
Purpose of the Study:
- To compare the risk of stillbirth in singleton pregnancies conceived through IVF/ICSI, non-IVF ART, and spontaneously in subfertile women versus fertile women.
- To determine if confounding factors explain the association between fertility treatment and stillbirth.
- To elucidate the role of fertility treatment versus subfertility in stillbirth risk.
Main Methods:
- Prospective data collection from the Aarhus Birth Cohort (1989-2006).
- Inclusion of 20,166 singleton pregnancies.
- Stillbirth as the primary outcome measure.
Main Results:
- The stillbirth rate was 16.2 per thousand for IVF/ICSI, 2.3 per thousand for non-IVF ART, 3.7 per thousand for fertile women, and 5.4 per thousand for subfertile women.
- Women conceiving via IVF/ICSI had over four times the risk of stillbirth compared to fertile women (OR: 4.44, 95% CI: 2.38-8.28).
- Adjustments for maternal age, BMI, education, and lifestyle factors minimally impacted the observed increased risk (OR: 4.08; 95% CI: 2.11-7.93).
- No significant difference in stillbirth risk was found for non-IVF ART or spontaneous conception after a year of trying compared to shorter conception times.
Conclusions:
- Women conceiving via IVF/ICSI face a significantly increased stillbirth risk compared to fertile women.
- This elevated risk is not attributable to known confounding factors, suggesting a direct link to the IVF/ICSI procedure or associated unknown factors.
- The findings highlight the need for further investigation into the mechanisms underlying the increased stillbirth risk following IVF/ICSI.
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