Hum. Reprod. Advance Access originally published online on October 5, 2006
Human Reproduction 2006 21(12):3228-3234; doi:10.1093/humrep/del311
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Does subfertility explain the risk of poor perinatal outcome after IVF and ovarian hyperstimulation?
1 Division of Reproductive Medicine, Department of Gynaecology, Leiden University Medical Center, Leiden 2 Department of Epidemiology, Netherlands Cancer Institute, Amsterdam 3 Department of Gerontology and Geriatrics 4 Department of Obstetrics and Gynaecology, Erasmus Medical Centre, Rotterdam and 5 Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
6 To whom correspondence should be addressed at: Division of Reproductive Medicine, Department of Gynaecology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands. E-mail: f.m.helmerhorst{at}lumc.nl
BACKGROUND: The primary objective of this study was to investigate whether subfertility explains poor perinatal outcome after assisted conception. A secondary objective was to test the hypothesis that ovarian hyperstimulation rather than the IVF procedure may influence the perinatal outcome. METHODS: Using data from a Dutch population-based historical cohort of women treated for subfertility, we compared perinatal outcome of singletons conceived after controlled ovarian hyperstimulation (COHS) and IVF (IVF + COHS; n = 2239) with perinatal outcome in subfertile women who conceived spontaneously (subfertile controls; n = 6343) and in women who only received COHS (COHS only; n = 84). Furthermore, we compared perinatal outcome of singletons conceived after the transfer of thawed embryos with (Stim + Cryo; n = 66) and without COHS (Stim – Cryo; n = 73). RESULTS: The odds ratios (ORs) for very low birthweight (<1500 g) and low birthweight (1500–2500 g) were 2.8 [95% confidence interval (95% CI) 1.9–3.9] and 1.6 (95% CI 1.2–1.8) in the IVF + COHS group compared with the subfertile control group. The ORs for very preterm birth (<32 weeks) and for preterm birth (32–37 weeks) were 2.0 (95% CI 1.4–2.9) and 1.5 (95% CI 1.3–1.8), respectively. Adjustment for confounders did not materially change these risk estimates. The difference in risk between the COHS-only group and the subfertile group was significant only for very low birthweight (OR 3.5; 95% CI 1.1–11.4), but the association became weaker after adjustment for maternal age and primiparity (OR 3.1; 95% CI 1.0–10.4). No significant difference in birthweight and preterm delivery was found between the group of children conceived after ovarian stimulation/ovulation induction and (Stim + Cryo) and the group of children conceived after embryo transfer of thawed embryos in a spontaneous cycle without ovarian stimulation/ovulation induction (Stim – Cryo). CONCLUSIONS: The poor perinatal outcome in this database could not be explained by subfertility and suggests that other factors may be important in the known association between assisted conception and poor perinatal outcome.
Key words: adverse effects/low birthweight/ovulation induction/pregnancy outcome/premature infant
E.de Boer, C.W.Burger and F.E.van Leeuwen: On behalf of the OMEGA project group of which members are listed in the Acknowledgement section.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  K.J. Middelburg, M.J. Heineman, A.F. Bos, M. Pereboom, V. Fidler, and M. Hadders-Algra The Groningen ART cohort study: ovarian hyperstimulation and the in vitro procedure do not affect neurological outcome in infancy Hum. Reprod., September 12, 2009; (2009) dep310v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Hansen, L. Colvin, B. Petterson, J. J. Kurinczuk, N. de Klerk, and C. Bower Twins born following assisted reproductive technology: perinatal outcome and admission to hospital Hum. Reprod., September 1, 2009; 24(9): 2321 - 2331. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Hvidtjorn, L. Schieve, D. Schendel, B. Jacobsson, C. Svaerke, and P. Thorsen Cerebral Palsy, Autism Spectrum Disorders, and Developmental Delay in Children Born After Assisted Conception: A Systematic Review and Meta-analysis Arch Pediatr Adolesc Med, January 1, 2009; 163(1): 72 - 83. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.F.G. Verberg, N.S. Macklon, G. Nargund, R. Frydman, P. Devroey, F.J. Broekmans, and B.C.J.M. Fauser Mild ovarian stimulation for IVF Hum. Reprod. Update, January 1, 2009; 15(1): 13 - 29. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Griesinger, E.M. Kolibianakis, K. Diedrich, and M. Ludwig Ovarian stimulation for IVF has no quantitative association with birthweight: a registry study Hum. Reprod., November 1, 2008; 23(11): 2549 - 2554. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. H. Ramlau-Hansen, A. M. Thulstrup, J. Olsen, and J. P. Bonde Parental Subfecundity and Risk of Decreased Semen Quality in the Male Offspring: A Follow-up Study Am. J. Epidemiol., June 15, 2008; 167(12): 1458 - 1464. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B.C. Jacod, K.D. Lichtenbelt, G.H. Schuring-Blom, J.S.E. Laven, D. van Opstal, M.J.C. Eijkemans, N.S. Macklon, and on behalf of the IVF-CPM Study Group Does confined placental mosaicism account for adverse perinatal outcomes in IVF pregnancies? Hum. Reprod., May 1, 2008; 23(5): 1107 - 1112. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. M. Chambers, M. G. Chapman, N. Grayson, M. Shanahan, and E. A. Sullivan Babies born after ART treatment cost more than non-ART babies: a cost analysis of inpatient birth-admission costs of singleton and multiple gestation pregnancies Hum. Reprod., December 1, 2007; 22(12): 3108 - 3115. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Poikkeus, M. Gissler, L. Unkila-Kallio, C. Hyden-Granskog, and A. Tiitinen Obstetric and neonatal outcome after single embryo transfer Hum. Reprod., April 1, 2007; 22(4): 1073 - 1079. [Abstract] [Full Text] [PDF]
|
|