ASSISTED REPRODUCTIVE TECHNOLOGY AND INCREASED ABNORMAL PLACENTATION: A POPULATION-BASED ANALYSIS

ObjectiveTo estimate the prevalence of low-prognosis patients according to the POSEIDON criteria using real-world data.DesignMulticenter population-based cohort study.SettingsFertility clinics in Brazil, Turkey, and Vietnam.PatientsInfertile women undergoing assisted reproductive technology using standard ovarian stimulation with exogenous gonadotropins.InterventionsNone.Main outcome measuresPer-period prevalence rates of POSEIDON patients (overall, stratified by POSEIDON groups and by study center) and the effect of covariates on the probability that a patient be classified as “POSEIDON”.ResultsA total of 13,146 patients were included. POSEIDON patients represented 43.0% (95% confidence interval [CI] 42.0–43.7) of the studied population, and the prevalence rates varied across study centers (range: 38.6–55.7%). The overall prevalence rates by POSEIDON groups were 44.2% (group 1; 95% CI 42.6–45.9), 36.1% (group 2; 95% CI 34.6–37.7), 5.2% (group 3; 95% CI 4.5–6.0), and 14.4% (group 4; 95% CI: 13.3–15.6). In general, POSEIDON patients were older, had a higher body mass index (BMI), lower ovarian reserve markers, and a higher frequency of female factor as the primary treatment indication than non-POSEIDON patients. The former required larger doses of gonadotropin for ovarian stimulation, despite achieving a 2.5 times lower number of retrieved oocytes than non-POSEIDON patients. Logistic regression analyses revealed that female age, BMI, ovarian reserve, and a female infertility factor were relevant predictors of the POSEIDON condition.ConclusionsThe estimated prevalence of POSEIDON patients in the general population undergoing ART is significant. These patients differ in clinical characteristics compared with non-POSEIDON patients. The POSEIDON condition is associated with female age, ovarian reserve, BMI, and female infertility. Efforts in terms of diagnosis, counseling, and treatment are needed to reduce the prevalence of low-prognosis patients.

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Assisted reproductive technology and the risk of pediatric cancer: A population based study and a systematic review and meta analysis

Cancer Epidemiology ◽

10.1016/j.canep.2019.101613 ◽

2019 ◽

Vol 63 ◽

pp. 101613 ◽

Cited By ~ 5

Author(s):

Daniella Gilboa ◽

Gideon Koren ◽

Yael Barer ◽

Rachel Katz ◽

Ram Rotem ◽

...

Keyword(s):

Systematic Review ◽

Assisted Reproductive Technology ◽

Pediatric Cancer ◽

Meta Analysis ◽

Population Based ◽

Reproductive Technology ◽

Population Based Study

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Trends in Multiple Births Conceived Using Assisted Reproductive Technology, United States, 1997–2000

PEDIATRICS ◽

10.1542/peds.111.s1.1159 ◽

2003 ◽

Vol 111 (Supplement_1) ◽

pp. 1159-1162 ◽

Cited By ~ 8

Author(s):

Meredith A. Reynolds ◽

Laura A. Schieve ◽

Joyce A. Martin ◽

Gary Jeng ◽

Maurizio Macaluso

Keyword(s):

United States ◽

Assisted Reproductive Technology ◽

The United States ◽

Population Based ◽

Reproductive Technology ◽

Multiple Births ◽

Multiple Gestation ◽

Birth Rates ◽

Live Births ◽

Natural Conception

Objective. To examine trends in multiple births conceived using assisted reproductive technology (ART) in the United States between 1997 and 2000 and to estimate the proportion of all US multiple births attributable to ART use. Methods. We analyzed population-based data of 109 519 live-born infants who were conceived in the United States using ART and born between 1997 and 2000 and population-based data of 15 856 809 live-born infants who were delivered in the United States between 1997 and 2000. Multiple birth rates (the number of live-born infants delivered in multiple gestation pregnancies per 1000 live births) and the proportion of all US multiple births attributable to ART were evaluated. Results. The twin rate for ART patients increased between 1997 and 2000, reaching 444.7 per 1000 live births in 2000, whereas the triplet/+ rate declined substantially from 134.3 to 98.7 per 1000 live births from 1997–2000. From 1997–2000, the proportion of multiple births in the United States attributable to ART increased from 11.2% to 13.6%, whereas the proportion attributable to natural conception decreased from 69.9% to 64.5%. In 2000, the proportion of triplet/+ births attributable to ART and to natural conception was 42.5% and 17.7%, respectively. The contribution of ART to multiple births increased substantially with maternal age, from 11.6% for triplet/+ infants born to women aged 20 to 24 to 92.8% for women aged 45 to 49 years. Conclusions. The contribution of ART to twin birth rates continues to increase, but the contribution of ART to triplet/+ birth rates has declined.

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