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An audit of the obstetric outcome of 148 consecutive pregnancies from assisted conception: implications for neonatal
1Ninewells Hospital and Medical School, Dundee.
Objective:
To assess the outcome of pregnancy following assisted conception.
Design:
Cohort descriptive study.
Setting:
Unit of Reproductive Medicine, Ninewells Hospital and Medical School.
Subjects:
One hundred and forty-eight consecutive assisted conceptions.
Main Outcome Measures:
Patient characteristics and outcome of pregnancy.
Results:
Seventy-nine percent of mothers were aged between 26 and 35 years (mean 31.4). The main causes of infertility were tubal (48%), unexplained (35%), anovulatory (8%) and male factor (8%). Primary infertility accounted for 61% of cases and 82% of pregnancies occurred within 3 treatment cycles. Thirty-five (24%) pregnancies miscarried before 14 weeks and 7 (5%) between 15 and 24 weeks gestation. One hundred and three pregnancies resulted in 136 liveborn infants. There was one neonatal death. Thirty-five babies were admitted to SCBU. Antenatally, 13% of patients were admitted to hospital with hypertension and 8% with APH; 50% of multiple and 13% of singleton pregnancies were delivered prematurely, 68% following preterm labour. There were 28 sets of twins (four miscarried at less than 24 weeks) and four sets of triplets. Multiple pregnancy was not associated with cause of infertility, treatment, age or ovarian hyperstimulation syndrome. Seventy-eight per cent of singletons and 50% of multipara were delivered vaginally.
Conclusions:
Our data confirm the high incidence of pregnancy loss and preterm delivery associated with assisted conception once allowing for the high rate of multiple pregnancies. The effect of assisted conception programme on health services is discussed.