Differential effect of mode of conception and infertility treatment on fetal growth and prematurity

Abstract

Objectives To examine perinatal outcomes in pregnancies conceived by different methods: fertile women with spontaneous pregnancies, infertile women who achieved pregnancy without treatment, pregnancies achieved by ovulation induction (OI) and in vitro fertilization or intra-cytoplasmic sperm injection (IVF/ICSI).

Methods Retrospective single-center cohort study including 200 fertile and 748 infertile women stratified according to infertility treatment. The outcome measurements were preterm delivery (PTD), small-for-gestational-age (SGA), gestational diabetes, placenta previa or preeclampsia.

Results The overall rate of pregnancy complications was significantly increased in all infertility groups regardless of the infertility treatment (adjusted odds ratio (OR): infertile without treatment 2.3 versus OI 2.2 versus IVF/ICSI 3.4). While PTD was mainly associated to IVF/ICSI (adjusted OR: infertile without treatment 1.3 versus OI 1.6 versus IVF/ICSI 3.3), SGA was significantly associated to both OI and IVF/ICSI (adjusted OR: infertile without treatment 1.9 versus OI 2.7 versus IVF/ICSI 2.6). All these associations remained statistically significant after adjusting by maternal age and twin pregnancy.

Conclusions This study confirms the higher prevalence of pregnancy complications in infertile women irrespectively of receiving infertility treatment or not, and further describes a preferential association of prematurity with IVF/ICSI, and SGA with treated infertility (OI and IVF/ICSI).

• Assisted reproductive technologies
• intrauterine growth restriction
• low birth weight
• perinatal outcome
• small for gestational age

Acknowledgements

This work was supported by grants from Instituto de Salud Carlos III [grant number PI11/00051, PI12/00801], from the Ministerio de Economía y Competitividad [grant number SAF2012–37196], cofinanced by the Fondo Europeo de Desarrollo Regional de la Unión Europea “Una manera de hacer Europa”, Fundación Mutua Madrileña, Obra Social la Caixa, Fundació Agrupació Mutua (Spain) and Cerebra Foundation for the Brain Injured Child (Carmarthen, Wales, UK). B.V.A. was supported by Programa de Ayudas Predoctorales FI Agaur (2013FI_B 00667) and wishes to express her gratitude to the Mexican National Council of Science and Technology (CONACyT, Mexico City, Mexico) for partially supporting her predoctoral stay at Hospital Clínic, Barcelona, Spain.

Declaration of interest

The authors report no declarations of interest.

Supplementary material available online