Segmented ART - The new era in ART?

Area of Science:

• Reproductive Medicine
• Obstetrics and Gynecology
• Perinatology

Background:

• Assisted reproductive technology (ART) accounts for up to 4% of infant conceptions in developing nations.
• ART procedures, while often successful, carry risks of iatrogenesis (medically induced harm).
• Controlled ovarian stimulation (COS) can alter the endocrine profile, potentially impacting implantation and fetal development.

Purpose of the Study:

• To review the clinical and scientific evidence of iatrogenesis in ART.
• To evaluate the evolution of ART technologies and their impact on maternal and fetal outcomes.
• To assess the benefits of frozen embryo transfer (FET) over fresh embryo transfer (ET).

Main Methods:

• Review of existing clinical and scientific literature on iatrogenesis in ART.
• Analysis of the effects of controlled ovarian stimulation on reproductive cycles and outcomes.
• Evaluation of evidence supporting frozen embryo transfer versus fresh embryo transfer.

Main Results:

• COS can lead to ovarian hyperstimulation syndrome, reduced implantation, ectopic pregnancy, and altered placentation/fetal growth.
• Frozen embryo transfer (FET) is increasingly presumed to be more optimal than fresh embryo transfer for reproductive, maternal, and fetal outcomes.
• GnRH agonist (GnRHa) trigger in segmented ART shows promise for improved patient outcomes.

Conclusions:

• Segmented ART with GnRHa trigger may become a future standard for IVF patients.
• FET appears superior to fresh ET regarding maternal and fetal health.
• ART advancements aim to minimize iatrogenesis and enhance safety and efficacy.