International Journal of
Reproductive Biomedicine
Mon, Dec 23, 2024
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Volume 13, Issue 3 (3-2015)
IJRM 2015, 13(3): 169-180 |
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Jie Z, Yiling D, Ling Y. Association of assisted reproductive technology with adverse pregnancy outcomes. IJRM 2015; 13 (3) :169-180
URL: http://ijrm.ir/article-1-631-en.html
URL: http://ijrm.ir/article-1-631-en.html
1- Department of Obstetrics and Gynecology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China
2- Department of Obstetrics and Gynecology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China ,dingyilingcsu@sina.cn
2- Department of Obstetrics and Gynecology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, People’s Republic of China ,
Abstract: (2899 Views)
Background: More and more infertile patients have accepted the assisted reproductive technique (ART) therapy. Concerns have been raised over an increased risk of adverse maternal outcomes in ART populations as compared with natural conception (NC).
Objective: The aim was to improve the ART in clinicial work and to reduce the incidence of pregnancy complications in ART group according to analyzing the reasons of high incidence of pregnancy complications in ART group, comparing the incidence of pregnancy complications in different controlled ovarian hyperstimulation (COH) programs and evaluating the effects of ART which attribute to adverse pregnancy outcomes.
Materials and Methods: In this prospective population-based cohort study,3216 pregnant women with gestational age ≤12 weeks, regular antenatal examination,and ultrasound identification of intrauterine pregnancy were enrolled from January 2010 to June 2013. According to having ART history, the participantswere divided into two groups: ART group (contains fresh embryo transfer group or frozen-thawed embryo transfer group) and NC group. We compared the incidence of pregnancy complications between different groups and evaluated the factors which could affect the occurrence of these complications.
Results: When compared to NC group, significantly increased rates of gestational diabetes mellitus (GDM) (p<0.01), preeclampsia (PE) (p<0.01) and intrahepatic cholestasis of pregnancy (ICP) (p˂0.01) were observed in ART group. There was no significant difference in the incidence of birth defect between the two groups (p=0.07). Multiple pregnancies and Gonadotropin (Gn) were risk factors in GDM, PE, and ICP. The exogenous progesterone treatment had no effect on GDM, PE or ICP.
Conclusion: ART increases the risk of adverse maternal complications such as GDM, PE and ICP. The dosages of Gn should be reduced to an extent and the number of embryo implantation should be controlled. Exogenous progesterone treatment is safe.
Objective: The aim was to improve the ART in clinicial work and to reduce the incidence of pregnancy complications in ART group according to analyzing the reasons of high incidence of pregnancy complications in ART group, comparing the incidence of pregnancy complications in different controlled ovarian hyperstimulation (COH) programs and evaluating the effects of ART which attribute to adverse pregnancy outcomes.
Materials and Methods: In this prospective population-based cohort study,3216 pregnant women with gestational age ≤12 weeks, regular antenatal examination,and ultrasound identification of intrauterine pregnancy were enrolled from January 2010 to June 2013. According to having ART history, the participantswere divided into two groups: ART group (contains fresh embryo transfer group or frozen-thawed embryo transfer group) and NC group. We compared the incidence of pregnancy complications between different groups and evaluated the factors which could affect the occurrence of these complications.
Results: When compared to NC group, significantly increased rates of gestational diabetes mellitus (GDM) (p<0.01), preeclampsia (PE) (p<0.01) and intrahepatic cholestasis of pregnancy (ICP) (p˂0.01) were observed in ART group. There was no significant difference in the incidence of birth defect between the two groups (p=0.07). Multiple pregnancies and Gonadotropin (Gn) were risk factors in GDM, PE, and ICP. The exogenous progesterone treatment had no effect on GDM, PE or ICP.
Conclusion: ART increases the risk of adverse maternal complications such as GDM, PE and ICP. The dosages of Gn should be reduced to an extent and the number of embryo implantation should be controlled. Exogenous progesterone treatment is safe.
Type of Study: Original Article |
References
1. Liu J, Larsen U, Wyshak G. Prevalence of primary infertility in China: in-depth analysis of infertility differentials in three minority province/ autonomous regions. J Biosoc Sci 2005; 37: 55-74. [DOI:10.1017/S0021932003006461]
2. Human Fertilisation and Embryology Authority. Fertility Facts and Figures 2007. Latest annual figures: 3-4.
3. Reynolds MA, Schieve LA, Martin JA, Jeng G, Macaluso M. Trends in multiple births conceived using assisted reproductive technology, United States, 1997-2000. Pediatrics 2002; 111: 1159-1162.
4. Human Fertilization and Embryology Authority. Fertility Treatment in 2010. Trends and Figures: 4-6.
5. Tallo CP, Vohr B, Oh W, Rubin LP, Seifer DB, Haning RV Jr. Maternal and neonatal morbidity associated with in vitro fertilization. J Pediatr 1995; 127: 794-800. [DOI:10.1016/S0022-3476(95)70175-3]
6. Koudstaal J, Braat DD, Bruinse HW, Naaktgeboren N, Vermeiden JP, Visser GH. Obstetric outcome of singleton pregnancies after IVF: a matched control study in four Dutch university hospitals. Hum Reprod 2000; 15: 1819-1825. [DOI:10.1093/humrep/15.8.1819]
7. Helmerhorst FM, Perquin DA, Donker D, Keirse MJ. Perinatal outcome of singletons and twins after assisted conception: a systematic review of controlled studies. BMJ 2004; 328: 261. [DOI:10.1136/bmj.37957.560278.EE]
8. Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, Damm P, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010; 33: 676-682. [DOI:10.2337/dc10-0719]
9. ACOG Committee on Obstetric Practice. American College of Obstetricians and Gynecologists (2002) Diagnosis and management of preeclampsia and eclampsia. American College of Obstetricians and Gynecologists. Int J Gynecol Obstet 2002; 77: 67-75.
10. Lee RH, Kwok KM, Ingles S, Wilson ML, Mullin P, Incerpi M, et al. Pregnancy Outcomes during an Era of Aggressive Management for Intrahepatic Cholestasis of Pregnancy. Am J Perinatol 2008; 25: 341-345. [DOI:10.1055/s-2008-1078756]
11. SadowCA, SahniVA. Imaging female infertility. Abdom Imaging 2014; 39: 92-107. [DOI:10.1007/s00261-013-0040-6]
12. Tukeva TA, Aronen HJ, Karjalainen PT, Molander P, Paavonen T, Paavonen J. MR imaging in pelvic inflammatory disease: comparison with laparoscopy and US. Radiology 1999; 210: 209-216. [DOI:10.1148/radiology.210.1.r99ja04209]
13. Romundstad LB, Romundstad PR, Sunde A, von Düring V, Skjaerven R, Gunnell D, et al. Effects of technology or maternal factors on perinatal outcome after assisted fertilization: a population-based cohort study. Lancet 2008; 372: 737-743. [DOI:10.1016/S0140-6736(08)61041-7]
14. O'Dwyer V, O'Toole F, Darcy S, Farah N, Kennelly MM, Turner MJ. Maternal obesity and gestational weight gain. J Obstet Gynaecol 2013; 33: 671-674. [DOI:10.3109/01443615.2013.821461]
15. Hsieh TT, Liou JD, Hsu JJ, Lo LM, Chen SF, Hung TH. Advanced maternal age and adverse perinatal outcomes in an Asian population. Eur J Obstet Gynecol Reprod Biol 2010; 148: 21-26. [DOI:10.1016/j.ejogrb.2009.08.022]
16. Ngowa JD, Ngassam AN, Dohbit JS, Nzedjom C, Kasia JM. Pregnancy outcome at advanced maternal age in a group of African women in two teaching Hospitals in Yaounde, Cameroon. Pan Afr Med J 2013; 14: 134.
17. Australian In Vitro Fertilisation Collaborative Group. High incidence of preterm births and early losses in pregnancy after in vitro fertilisation. BMJ 1985; 291: 1160-1163. [DOI:10.1136/bmj.291.6503.1160]
18. Alastair G Sutcliffe, Michael Ludwig. Outcome of assisted reproduction. Lancet 2007; 370: 351-359. [DOI:10.1016/S0140-6736(07)60456-5]
19. Schlossberger V, Schober L, Rehnitz J, Schaier M, Zeier M, Meuer S, et al. The success of assisted reproduction technologies in relation to composition of the total regulatory T cell (Treg) pool and different Treg subsets. Hum Reprod 2013; 28: 3062-3073. [DOI:10.1093/humrep/det316]
20. Nakashima A, Ito M, Yoneda S, Shiozaki A, Hidaka T, Saito S. Circulating and decidual Th17 cell levels in healthy pregnancy. Am J Reprod Immunol 2010; 63: 104-109. [DOI:10.1111/j.1600-0897.2009.00771.x]
21. Kalu E, Bhaskaran S, Thum MY, Vishwanatha R, Croucher C, Sherriff E, et al. Serial Estimation of Th1:Th2 Cytokines Profile in Women Undergoing In-Vitro Fertilization-Embryo Transfer. Am J Reprod Immunol 2008; 59: 206-211. [DOI:10.1111/j.1600-0897.2007.00565.x]
22. Smirnakis KV, Martinez A, Blatman KH, Wolf M, Ecker JL, Thadhani R. Early Pregnancy Insulin Resistance and Subsequent Gestational Diabetes Mellitus. Diabetes Care 2005; 28: 1207-1208. [DOI:10.2337/diacare.28.5.1207]
23. Allen VM, Wilson RD. Pregnancy outcomes after assisted reproductive technology. J Obstet Gynaecol Can 2006; 28: 220-250. [DOI:10.1016/S1701-2163(16)32112-0]
24. Taşcilar ME, Bilir P, Akinci A, Köse K, Akçora D, Inceoğlu D, et al. The effect of gonadotropin-releasing hormone analog treatment (leuprolide) on body fat distribution in idiopathic central precocious puberty.Turkish J Pediatr 2011; 53: 27-33.
25. Dickerson EH, Cho LW, Maguiness SD, Killick SL, Robinson J, Atkin SL. Insulin resistance and free androgen index correlate with the outcome of controlled ovarian hyperstimulation in non-PCOS women undergoing IVF. Hum Reprod 2010; 25: 504-509. [DOI:10.1093/humrep/dep393]
26. Pieard F, Wanatabe M, Schoonjans K.Progesterone receptor knockout mice have an improved glucose homeostasis secondary to beta-cell proliferation. Proc Natl Acad Sci USA 2002; 99: 15644-15648. [DOI:10.1073/pnas.202612199]
27. Couch SC, Philipson EH, Bendel RB, Pujda LM, Milvae RA, Lammi-Keefe CJ. Elevated lipoprotein lipids and gestational hormones in women with diet-treated gestational diabetes mellitus compared to healthy pregnant controls. J Diabetes Complications 1998; 12: 1-9. [DOI:10.1016/S1056-8727(97)00007-X]
28. Chen R, Fisch B, Ben-Haroush A, Kaplan B, Hod M, Orvieto R.Serum and follicular fluid leptin levels in patients undergoing controlled ovarian hyperstimulation for in vitro fertilization cycle. Clin Exp Obstet Gynecol 2004; 31: 103-106.
29. Chakrabarti J, Chatterjee R, Goswami S, Chakravarty B, Kabir SN.Overt leptin response to controlled ovarian hyperstimulation negatively correlates with pregnancy outcome in in vitro fertilization-embryo transfer cycle. J Hum Reprod Sci 2012;5:194-199. [DOI:10.4103/0974-1208.101021]
30. Moschos S, Chan JL, Christos S. Mantzoros. Leptin and reproduction: a review. FertilSteril 2002; 77: 433-441. [DOI:10.1016/S0015-0282(01)03010-2]
31. Manisha SD. Association between Twin Pregnancy and Hyperglycemia in a Multiethnic Community in New Zealand. Diabetes Care 2002; 25: 934-935. [DOI:10.2337/diacare.25.5.934]
32. Corrado F, Caputo F, Facciolà G, Mancuso A.Gestational Glucose Intolerance in Multiple Pregnancy. Diabetes Care 2003: 26: 1646. [DOI:10.2337/diacare.26.5.1646]
33. Sivan E, Maman E, Homko CJ, Lipitz S, Cohen S, Schiff E. Impact of fetal reduction on the incidence of gestational diabetes. Obstet Gynecol 2002; 99: 91-94.
34. Jackson RA, Gibson KA, Wu YW, Croughan MS. Perinatal outcomes in singletons following in vitro fertilization: a meta-analysis. Obstet Gynecol 2004; 103: 551-563. [DOI:10.1097/01.AOG.0000114989.84822.51]
35. Schieve LA, Cohen B, Nannini A, Ferre C, Reynolds MA, Zhang Z, et al. A population-based study of maternal and perinatal outcomes associated with assisted reproductive technology in Massachusetts. Matern Child Health J 2007; 11: 517-525. [DOI:10.1007/s10995-007-0202-7]
36. Sazonova A, Källen K, Thurin-Kjellberg A, Wennerholm UB, Bergh C. Factors affecting obstetric outcome of singletons born after IVF. Hum Reprod 2011; 26: 2878-2886. [DOI:10.1093/humrep/der241]
37. Sazonova A, Källen K, Thurin-Kjellberg A, Wennerholm UB, Bergh C. Obstetric outcome after in vitro fertilization with single or double embryo transfer. Hum Reprod 2011; 26: 442-450. [DOI:10.1093/humrep/deq325]
38. El Shahat AM, Ahmed AB, Ahmed MR, Mohamed HS. Maternal serum leptin as a marker of preeclampsia. Arch Gynecol Obstet 2013; 288: 1317-1322. [DOI:10.1007/s00404-013-2915-8]
39. D'Anna R, Baviera G, Corrado F, Giordano D, Di Benedetto A, Jasonni VM. Plasma adiponectin concentration in early pregnancy and subsequent risk of hypertensive disorders. Obstet Gynecol 2005; 106: 340. [DOI:10.1097/01.AOG.0000168441.79050.03]
40. Svoboda J, Ruzickova Z, Cuchalova L, Kralickova M, Rezacova J, Vrana M, et al. Ovulation stimulation protocols utilizing GnRH-antagonist/hCG, promote cytotoxic cell populations, predominant in patients with embryo implantation complications. Neuro Endocrinol Lett 2013; 34: 249-257.
41. Sibai BM, Hauth J, Caritis S, Lindheimer MD, MacPherson C, Klebanoff M, et al. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. Hypertensive disorders in twin versus singleton gestations. Am J Obstet Gynecol 2000; 182: 938-942. [DOI:10.1016/S0002-9378(00)70350-4]
42. Bdolah Y, Lam C, Rajakumar A, Shivalingappa V, Mutter W, Sachs BP, et al. Twin pregnancy and the risk of preeclampsia: bigger placenta or relative ischemia? Am J Obstet Gynecol 2008; 198: 428. [DOI:10.1016/j.ajog.2007.10.783]
43. Fox NS, Roman AS, Saltzman DH, Hourizadeh T, Hastings J, Rebarber A. Risk factors for preeclampsia in twin pregnancies. Am J Perinatol 2014; 31: 163-166.
44. Lan RY, Salunga TL, Tsuneyama K, Lian ZX, Yang GX, Hsu W, et al. Hepatic IL-17 responses in human and murine primary biliary cirrhosis. J Autoimmun 2009; 32: 43-51. [DOI:10.1016/j.jaut.2008.11.001]
45. Gonzalez MC, Reyes H, Arrese M, Figueroa D, Lorca B, Andresen M, et al. Intrahepatic cholestasis of pregnancy in twin pregnancies. J Hepatol 1989;9:84-90. [DOI:10.1016/0168-8278(89)90079-2]
46. Verlaenen H, Cammu H, Derde MP, Amy JJ. Singleton pregnancy after in vitro fertilization: expectations and outcome. Obstet Gynecol 1995; 86: 906-910. [DOI:10.1016/0029-7844(95)00322-I]
47. Romundstad LB, Romundstad PR, Sunde A, von Düring V, Skjaerven R, Vatten LJ. Increased risk of placenta previa in pregnancies following IVF/ICSI: a comparison of ART and non-ART pregnancies in the same mother. Hum Reprod 2006; 21: 2353-2358. [DOI:10.1093/humrep/del153]
48. Mukhopadhaya N, Arulkumaran S. Reproductive outcomes after in-vitro fertilization. CurrOpin Obstet Gynecol 2007; 19: 113-119. [DOI:10.1097/GCO.0b013e32807fb199]
49. Pelkonen S, Koivunen R, Gissler M, Nuojua-Huttunen S, Suikkari AM, Hydén-Granskog C, et al. Perinatal outcome of children born after frozen and fresh embryo transfer: the Finnish cohort study 1995-2006. Hum Reprod 2010; 25: 914-923. [DOI:10.1093/humrep/dep477]
50. Sazonova A, Källen K, Thurin-Kjellberg A, Wennerholm UB, Bergh C. Obstetric outcome in singletons after in vitro fertilization with cryopreserved/thawed embryos. Hum Reprod 2012; 27: 1343-1350. [DOI:10.1093/humrep/des036]
51. Wen J, Jiang J, Ding C, Dai J, Liu Y, Xia Y, et al. Birth defects in children conceived by in vitro fertilization and intracytoplasmic sperm injection: a meta-analysis. Fertil Steril 2012; 97: 1331-1337. [DOI:10.1016/j.fertnstert.2012.02.053]
52. Davies MJ, Moore VM, Willson KJ, Van Essen P, Priest K, Scott H, et al. Reproductive technologies and the risk of birth defects. N Engl J Med 2012; 366: 1803-1813. [DOI:10.1056/NEJMoa1008095]
53. Bonduelle M, Van Assche E, Joris H, Keymolen K, Devroey P, Van Steirteghem A, et al.Prenatal testing in ICSI pregnancies: incidence of chromosomal anomalies in 1586 karyotypes and relation to sperm parameters. Hum Reprod 2002; 17: 2600-2614. [DOI:10.1093/humrep/17.10.2600]
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