Human Reproduction, Vol. 16, No. 12, 2691-2696,
December 2001
© 2001 European Society of Human Reproduction and Embryology
Mortality in a cohort of IVF patients
1 Centre for the Study of Mothers' and Children's Health, La Trobe University, Carlton 3053, 2 Menzies Centre for Population Health Research, University of Tasmania, GPO Box 252–23, Hobart 7001, Australia, 3 Stakes (the National Research and Development Centre for Welfare and Health), Helsinki 00531, Finland, 4 Department of Obstetrics and Gynaecology, Monash University, Clayton 3168 and 5 Monash IVF, Richmond 3121, Australia
BACKGROUND: Risks associated with IVF and related assisted reproduction technologies include complications of ovarian stimulation, surgical procedures and pregnancy itself. Serious complications are uncommon but may be potentially life threatening. The aims of this study were to compare the mortality rates of women who received IVF treatment, as well as those who were referred but were not treated, with the mortality rate in the general female population, to determine the maternal mortality rate following IVF conception and to establish whether any deaths had occurred as a result of treatment complications. METHODS: Deaths were identified in a cohort of 29 700 Australian IVF patients by record-linkage with the National Death Index and a cancer registry. RESULTS: The all-cause mortality rates in IVF patients (treated and untreated) were significantly lower than in the general female population of the same age. In treated women, 72 deaths were observed and 125 deaths were expected giving an age-standardized mortality ratio of 0.58 (95% confidence interval 0.48–0.69). Two maternal deaths were identified in the 42 days of the puerperium. Complications of ovarian hyperstimulation syndrome could not be directly related to any of the deaths identified in this cohort. CONCLUSIONS: As well as providing some reassurance about the safety of IVF treatments, the findings point to the existence of a `healthy patient effect' whereby the unhealthiest women in the population are deterred from pregnancy and infertility treatment.
Key words: complications of treatment/death/follow-up/IVF/maternal mortality
6 To whom correspondence should be addressed. E-mail: alison.venn{at}utas.edu.au
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