Assisted Reproductive Technology or Infertility: What underlies adverse outcomes? Lessons from the Massachusetts...

Area of Science:

• Reproductive Medicine
• Perinatal Epidemiology
• Developmental Pediatrics

Background:

• Assisted reproductive technology (ART) is associated with adverse pregnancy and neonatal outcomes, often compared to naturally conceived pregnancies.
• The Massachusetts Outcome Study of Assisted Reproductive Technology (MOSART) aimed to establish a comparison group of subfertile individuals for ART outcome studies.
• Long-term data collection in MOSART has enabled comprehensive analysis of maternal, infant, and child health following ART.

Purpose of the Study:

• To evaluate the influence of ART and subfertility on adverse pregnancy and delivery outcomes using the MOSART database.
• To compare ART-associated risks with those of subfertility/infertility alone.
• To investigate the role of placental abnormalities in ART-associated adverse outcomes.

Main Methods:

• Analysis of the MOSART database, a longitudinal study of over 10 years.
• Comparison of pregnancy and delivery outcomes between ART-conceived and subfertile populations.
• Examination of maternal and child hospitalizations and developmental outcomes.

Main Results:

• Subfertility/infertility independently increases the risk of adverse pregnancy outcomes, including hypertensive disorders and gestational diabetes.
• ART use confers an additional risk beyond that of subfertility for adverse pregnancy and delivery complications.
• Placental abnormalities are identified as a contributing factor to increased ART-associated risks.

Conclusions:

• Both subfertility and ART contribute to adverse pregnancy and neonatal outcomes.
• ART introduces specific risks, potentially mediated by factors like placental abnormalities.
• Longitudinal studies like MOSART are crucial for understanding the full spectrum of ART impacts on maternal and child health.