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PGT pregnancies have a similar risk for post-partum complications as naturally conceived pregnancies

Published:September 16, 2022DOI:https://doi.org/10.1016/j.rbmo.2022.09.009

      Abstract

      Research question

      Do preimplantation genetic testing (PGT) pregnancies have higher post-partum complications compared with naturally conceived pregnancies?

      Design

      Retrospective cohort study conducted in 2008–2020 at the Shaare Zedek Medical Center (SZMC), including all patients aged 18–45 years old who conceived following PGT with a singleton live birth >24 weeks. Data were collected from computerized hospital databases and patient files. There were two control groups: (i) pregnancies following IVF-ICSI (intracytoplasmic sperm injection); (ii) four neighbourhood controls for each case delivery (two women delivered before and two after) of women with naturally conceived pregnancies.

      Results

      Overall, 120 PGT, 779 IVF-ICSI and 3507 naturally conceived deliveries were included. Demographic variables were similar apart from slightly higher age in the PGT (P = 0.003) and ICSI (P = 0.002) groups (31.07 ± 4.38 PGT, 31.66 ± 5.03 ICSI, 28.77 ± 5.72 naturally conceived). Composite post-partum placental-related complications (manual lysis of placenta, revision of uterine cavity, haemoglobin drop ≥3 g/dl, post-partum haemorrhage, need for blood transfusion) were more prevalent in both the PGT and IVF-ICSI groups as opposed to naturally conceived (20.0% versus 18.9% versus 10.3%, respectively, P < 0.001, P = 0.007). In a multivariate regression model PGT was not found to be independently associated with composite post-partum placental-related complications (adjusted odds ratio [aOR] 1.44, 95% confidence interval [CI] 0.83–2.15), while IVF-ICSI pregnancies had increased risk (aOR 1.52, 95% CI 1.20–1.97) compared with natural conception. No difference was found between fresh and frozen cycles or between day 3 and day 5 embryo transfer.

      Conclusions

      PGT pregnancies have a comparable risk of post-partum placental-related complications to naturally conceived pregnancies, unlike IVF-ICSI pregnancies. It is possible that infertility itself is the main mediator for post-partum complications in IVF-ICSI pregnancies.

      Keywords

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      Biography

      Naama Srebnik is a Senior physician in the Fertility and IVF Unit at Shaare Zedek Medical Center, Jerusalem, Israel. In addition, she is a Lecturer at the Hebrew University School of Medicine. Furthermore, Dr Srebnik practises basic science research at the Hebrew University as part of her PhD studies, in addition to clinical research.
      Key message
      PGT pregnancies have a comparable risk of post-partum placental-related complications to naturally conceived pregnancies, while IVF-ICSI pregnancies have a higher risk. It is hypothesized that the biopsy does not harbour a deleterious effect on post-partum placental-related complications but rather infertility itself.