Abstract
Research question
What are the risk factors for prematurity other than intrauterine growth restriction
in singletons after in vitro fertilization?
Design
Data were collected from a national registry, based on an observational prospective
cohort of 30737 livebirths after assisted reproductive technologies (ART) between
2014 and 2015. A population of not-small-for-gestational-age singletons conceived
after fresh embryo transfers and frozen-thawed embryo transfers and their parents
was selected. Main collected data: parent's age, type of infertility, number of oocytes
retrieved, semen origin, type of fertilization, number of transferred embryos, embryo
age at transfer, vanishing twins, gestational age at birth, birthweight and sex.
Results
Data from 20 932 fresh embryo transfers and 9805 frozen-thawed embryo transfers of
singletons were collected. Preterm birth occurred in 7.7% (n=1607) of fresh embryo
transfers and 6.6% (n=611) of frozen-thawed embryo transfers (p<0.0001; adjusted OR = 1.34
[1.21-1.49]). Endometriosis, and vanishing twin increased the risk of preterm birth
after fresh embryo transfer (p<0.001; respectively aOR 1.32 and 1.78). Polycystic
ovaries or >20 oocytes retrieved also increased preterm birth risk (aOR 1.3; respectively
p =0.003 and p=0.02), while large oocyte cohort (>20) was no longer associated with
the risk of prematurity in case of frozen embryo transfer.
Conclusion
Endometriosis remains a risk of prematurity even in the absence of intrauterine growth
retardation, which suggests a dysimmune impact. Large oocyte cohorts obtained by stimulation,
without clinical PCOS diagnosed before attempts, have no further impact in case of
frozen embryo transfer, reinforcing the idea of a phenotypic difference in the clinical
presentation of PCOS.
Keywords
Abbreviations:
AMH (Anti-mullerian hormone), ART (Assisted Reproductive Technology), FET (Frozen embryos transfer), FGR (Fetal growth restriction), fresh-ET (Fresh embryos transfer), IVF (In vitro fertilization), Not-SGA (not-small-for-gestational-age), PCOS (Polycystic Ovary Syndrome)To read this article in full you will need to make a payment
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Biography
Marie-Jose Gervoise Boyer is a doctor specialising in reprotoxicity. She has been working since 1984 on the risks associated with pre-conception or in utero drug exposure and has extensive experience in paediatric pharmacovigilance. Since 2000, she has been interested in the follow-up of children born after medically assisted procreation.
Article info
Publication history
Accepted:
January 10,
2023
Received:
October 18,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Declarations of interest: none
Identification
Copyright
© 2023 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
