The Association of Assisted Reproductive Technology and Breastfeeding Rates: A Systematic Review and Meta-Analysis

There is an inconsistent result regarding the mode of fertilization and breastfeeding. This systematic review and meta-analysis aimed to determine the association between the mode of conception and breastfeeding continuity. The English electronic databases were searched for up to May 20, 2022. The Newcastle-Ottawa Quality Assessment Scale was used to evaluate the quality of the included studies. Publication bias was assessed using a funnel plot. The heterogeneity of studies was evaluated using I² statistics. Results of the random-effects meta-analysis were presented using odds ratios (ORs)/relative ratio (RR) and 95% confidence intervals (CIs). A total of 12 articles with 4,929 subjects were included in this systematic review and meta-analysis. The pool estimates of the meta-analysis show that spontaneous conception is associated with breastfeeding continuity up to 6 months (OR/RR = 0.66, 95% CI: 0.46-0.87) and more than 6 months after childbirth (OR/RR = 0.65, 95% CI: 0.32-0.98) compared to the Assisted reproductive technology (ART) conception. The heterogeneity among the studies was high. The level of breastfeeding, plurality, gestational age, and country were confounding factors that affect the heterogeneity of studies. Our findings confirm an inverse association between ART conception and breastfeeding continuity. Due to the importance of breast milk in improving the health of infants who are born in this way, it is recommended to take appropriate interventions in this field. Possible interaction between ART and breastfeeding continuity in different regions is important to point and future studies on this topic were recommended.