Assisted Conception Ups Adverse Pregnancy Risk

NEW YORK (Reuters Health) - Use of assisted reproductive technologies, including ovulation induction and in vitro fertilization (IVF), increases the risk of adverse pregnancy outcomes such as placental anomalies and miscarriage, new research shows.

However, the good news is that assisted reproduction does not increase the risk of fetal chromosomal or structural abnormalities, according to the report in the medical journal Obstetrics & Gynecology.

Dr. Tracy Shevell, from the Stamford Hospital in Connecticut, and colleagues analyzed data obtained on 36,062 singleton pregnancies to assess the effect of assisted reproduction on pregnancy outcomes. Of the pregnancies, 34,286 were conceived spontaneously, 1222 with the use of ovulation induction, and 554 with IVF.

After accounting for age, race, and other factors, the use of assisted reproductive technologies was not associated with fetal growth restriction or fetal anomalies.

Compared with women who conceived spontaneously, women who underwent ovulation induction were at increased risk for placental detachment, fetal loss after 24 weeks, and pregnancy-related diabetes.

Use of IVF was associated with even more adverse outcomes: preeclampsia (or toxemia of pregnancy), high blood pressure, other placental abnormalities, and risk of c-section, the report indicates.

"Clinicians caring for (patients treated with fertility therapy) should be aware of these possible associated adverse outcomes and may need to be vigilant for additional signs or complications during antenatal care," Shevell's team concludes.

On a more reassuring note, they point out that although heightened vigilance may be warranted, the odds of having a healthy baby with assisted reproduction are still "extremely high."

SOURCE: Obstetrics & Gynecology, November 2005.