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In Vitro Fertilization and Placenta Accreta (spectrum): A Systematic Review
Ana Carolina Wickert Theisen1, Nathália Fritsch Camargo2, Talita Colombo1
1UFCSPA Porto Alegre Rio Grande do Sul Brazil UFCSPA, Porto Alegre, Rio Grande do Sul, Brazil.
JBRA Assisted Reproduction
|February 27, 2026
Summary
In vitro fertilization (IVF) pregnancies show an increased risk of placenta accreta spectrum (PAS). Frozen embryo transfer may pose a higher risk, highlighting the need for specialized care in assisted reproductive technology pregnancies.
Area of Science:
- Reproductive Medicine and Obstetrics
- Maternal-Fetal Medicine
Background:
- In vitro fertilization (IVF) offers successful infertility treatment, especially for women under 35.
- IVF pregnancies carry risks of obstetric complications, including placenta accreta spectrum (PAS).
Purpose of the Study:
- To systematically review and compare the risk of PAS in IVF pregnancies versus spontaneous pregnancies.
- To identify additional obstetric complications associated with IVF pregnancies.
- To analyze maternal outcomes in PAS cases following assisted reproductive techniques (ART).
Main Methods:
- Systematic literature search across major databases (PubMed, Embase, Web of Science, etc.).
- Inclusion of original studies comparing spontaneous and IVF pregnancies; exclusion of case reports.
- Quality assessment using the Newcastle-Ottawa tool; data extraction on PAS and other complications.
Main Results:
- Analysis of 13 articles involving over 250,000 ART pregnancies and 16 million spontaneous pregnancies.
- Significantly increased risk of PAS in IVF pregnancies; frozen embryo transfer (FET) associated with higher risk than fresh transfer.
- Other complications include hypertension, preeclampsia, and intrauterine growth restriction (IUGR); lower ICU admission for PAS post-IVF noted.
Conclusions:
- Assisted reproductive technology (ART) is an independent risk factor for PAS, presenting a unique risk profile.
- Emphasizes the need for further research on maternal outcomes after ART and PAS.
- Highlights the importance of specialized prenatal diagnosis and follow-up for high-risk IVF pregnancies.
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