Abstract
Purpose: Our purpose was to determine the risk of premature delivery among singleton pregnancies derived from assisted reproduction technology (ART).
Methods: Ninety-five singleton ART pregnancies and 190 matched spontaneous pregnancies were assessed for preterm delivery rates, pregnancy complications, and cesarean section rates in a retrospective study at an academic medical center.
Results: Among the ART singleton deliveries group (n = 95), 19 (20%) were preterm, which was statistically significantly higher than the 4% (8 of 190) found in the control group. Among the pregnancies achieved by intracytoplasmic sperm injection (ICSI) in the severe male-factor infertility subgroup (n = 22), only one preterm delivery occurred (4.5%).
Conclusions: Singleton ART pregnancies are at an increased risk of preterm delivery compared to singleton pregnancies after spontaneous conception. The higher rate may be attributed to various infertility cofactors, such as uterine malformations, previous operative procedures that involved cervical dilatation, and a history of pelvic infection. This is supported by the finding that ICSI-derived pregnancies in couples with strict male-factor infertility are not at an increased risk of preterm delivery.
Keywords: preterm delivery, singleton pregnancy
Full Text
The Full Text of this article is available as a PDF (56.7 KB).
REFERENCES
- 1.Bergh T, Ericson A, Hillensjo T, Nygren KG, Wennerholm UB. Deliveries and children born after in-vitro fertilisation in Sweden 1982-95: A retrospective cohort study. Lancet. 1999;354:1579–1585. doi: 10.1016/S0140-6736(99)04345-7. [DOI] [PubMed] [Google Scholar]
- 2.Dhont M, De Sutter P, Ruyssinck G, Martens G, Bekaert A. Perinatal outcome of pregnancies after assisted reproduction: A case-control study. Am J Obstet Gynecol. 1999;181:688–695. doi: 10.1016/s0002-9378(99)70514-4. [DOI] [PubMed] [Google Scholar]
- 3.Wennerholm UB, Hanson PO, Wennergren M, Kjellmer I. Pregnancy complications and short-term follow-up of infants born after in vitro fertilization and embryo transfer (IVF/ET) Acta Obstet Gynecol Scand. 1991;70:565–573. doi: 10.3109/00016349109007918. [DOI] [PubMed] [Google Scholar]
- 4.McFaul PB, Patel N, Mills J. An audit of the obstetric outcome of 148 consecutive pregnancies from assisted conception: Implications for neonatal services. Br J Obstet Gynaecol. 1993;100:820–825. doi: 10.1111/j.1471-0528.1993.tb14306.x. [DOI] [PubMed] [Google Scholar]
- 5.Verlaenen H, Cammy 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. [DOI] [PubMed] [Google Scholar]
- 6.FIVNAT Pregnancies and births resulting from in vitro fertilization: French national registry, analysis of data 1986 to 1990. Fertil Steril. 1995;64:746–756. doi: 10.1016/s0015-0282(16)57850-9. [DOI] [PubMed] [Google Scholar]
- 7.Olivennes F, Rufat P, Andre B, Pourade A, Quiros MC, Frydman R. The increased risk of complication observed in singleton pregnancies resulting from in vitro fertilization (IVF) does not seem to be related to the IVF method itself. Hum Reprod. 1993;8:1297–1300. doi: 10.1093/oxfordjournals.humrep.a138245. [DOI] [PubMed] [Google Scholar]
- 8.Doyle P, Beral V, Maconochie N. Preterm delivery, low birth weight and small-for-gestational-age in liveborn singleton babies resulting from in-vitro fertilization. Hum Reprod. 1992;7:425–428. doi: 10.1093/oxfordjournals.humrep.a137663. [DOI] [PubMed] [Google Scholar]
- 9.Tanbo T, Dale P., Lunde O, Moe N, Obyholm T. Obstetric outcome in singleton pregnancies after assisted reproduction. Obstet Gynecol. 1995;86:188–192. doi: 10.1016/0029-7844(95)00159-o. [DOI] [PubMed] [Google Scholar]
- 10.Wang J, Clark A, Kirby C, Philipson G, Petrucco O, Anderson G, Matthews CD. The obstetric outcome of singleton pregnancies following in-vitro fertilization/Gamete intra-fallopian transfer. Hum Reprod. 1994;9:141–146. doi: 10.1093/oxfordjournals.humrep.a138304. [DOI] [PubMed] [Google Scholar]
- 11.Rubinoff BE, Samueloff A, Ben-Haim M, Fridler S, Schenker JG, Lewin A. Is the obstetric outcome of in vitro fertilized singleton gestations different from natural ones? A controlled study. Fertil Steril. 1997;67:1077–1083. doi: 10.1016/s0015-0282(97)81442-2. [DOI] [PubMed] [Google Scholar]
- 12.Wennerholm UB, Bergh C, Hamberger L, Nilsson L, Reismer E, Wennergren M, Wikland M. Obstetric and perinatal outcome of pregnancies following intracytoplasmic sperm injection. Hum Reprod. 1996;11:1113–1119. doi: 10.1093/oxfordjournals.humrep.a019307. [DOI] [PubMed] [Google Scholar]
- 13.Howe RS, Sayegh RA, Durinzi KL, Tureck RW. Perinatal outcome of singleton pregnancies conceived by in vitro fertilization: A controlled study. J Perinatol. 1990;10:261–266. [PubMed] [Google Scholar]
- 14.Bar-Hava I, Ashkenazi J, Shelef M, Schwartz A, Brengauz M, Feldberg D, et al. Morphology and clinical outcome of embryos after in vitro fertilization are superior to those after intracytoplasmic sperm injection. Fertil Steril. 1997;68:663–667. doi: 10.1016/s0015-0282(97)00265-3. [DOI] [PubMed] [Google Scholar]
- 15.Wisanto A, Magnus M, Bouduelle M, Liu J, Camus M, Tourmaye M, Liebaers I, Van Steirtegren AC, Devroey P. Obstetric outcome of 424 pregnancies after intracytoplasmic sperm injection. Hum Reprod. 1995;10:2713–2718. doi: 10.1093/oxfordjournals.humrep.a135773. [DOI] [PubMed] [Google Scholar]
- 16.Govaerts I, Devreker F, Koenig I, Place I, Van den Bergh M, Englert Y. Comparison of pregnancy outcome after ICSI and in-vitro fertilization. Hum Reprod. 1998;13:1514–1518. doi: 10.1093/humrep/13.6.1514. [DOI] [PubMed] [Google Scholar]
- 17.Maman E, Lunenfeld E, Levy A, Vardi H, Potashnik G. Obstetric outcome of singleton pregnancies conceived by in vitro fertilization and ovulation induction compared with those conceived spontaneously. Fertil Steril. 1998;70:240–245. doi: 10.1016/s0015-0282(98)00160-5. [DOI] [PubMed] [Google Scholar]
- 18.Wald NJ, White N, Morris JK, Huttly WJ, Canick JA. Serum markers for Down's syndrome in women who have had in vitro fertilisation: Implications for antenatal screening. Br J Obstet Gynaecol. 1999;106:1304–1306. doi: 10.1111/j.1471-0528.1999.tb08186.x. [DOI] [PubMed] [Google Scholar]
- 19.Walton DL, Norem CT, Schoen EJ, Ray GT, Colby CJ. Second-trimester serum chorionic gonadotropin concentrations and complications and outcome of pregnancy. N Engl J Med. 1999;341:2033–2038. doi: 10.1056/NEJM199912303412701. [DOI] [PubMed] [Google Scholar]
- 20.Gomez R, Ghezzi F, Romero R, Munoz H, Tolosa JE, Rojas I. Premature labor and intra-amniotic infection. Clinical aspects and role of the cytokines in diagnosis and pathophysiology. Clin Perinatol. 1995;22:281–342. [PubMed] [Google Scholar]
- 21.Gomez R, Romero R, Ghezzi F, Yoon BH, Mazor M, Verry SM. The fetal inflammatory response syndrome. Am J Obstet Gynecol. 1998;179:194–202. doi: 10.1016/s0002-9378(98)70272-8. [DOI] [PubMed] [Google Scholar]