Periconceptional folic acid and teratogenic drug use in women undergoing fertility treatments

Abstract

Objective: To evaluate periconception drug use in women undergoing fertility treatment and compare it to women with spontaneous pregnancies. Methods: Retrospective observational cohort study on reproductive-age women. Data on pregnancies, fertility treatments, prescription fillings and demographics were extracted from Clalit Health Services computerized systems. Two quality measures were evaluated: periconception folic acid prescription fillings and use of potentially hazardous drugs in early pregnancy. Results: There were 12,891 fertility treatment cycles in 4868 women; and 4968 women had spontaneous pregnancy. Periconceptional folic acid use was low and similar in both groups (31.3% of fertility cycles versus 29.9% of spontaneous pregnancies, p = 0.07). In the infertility group, 293 prescriptions for potentially hazardous drugs were filled within 45 days after the beginning of a fertility cycle (2.3% of cycles) compared to only 47 (0.9%) in women with spontaneous pregnancy (p < 0.001). Conclusions: The periconception medical care of women who undergo fertility treatment is suboptimal and is not better than in women with spontaneous pregnancies. Folic acid use that can reduce the risk of congenital anomalies is underused; whereas the use of potentially hazardous drugs in early pregnancy is significant. More intensive and targeted counseling regarding drug use before pregnancy is urgently needed.

Keywords::

• Fertility treatment
• folic acid use
• preconception care
• quality of medical care
• teratogenic drug use

Declaration of Interest: The authors report no conflicts of interest.