Perinatal and Childhood Outcomes Associated with Infertility

2017 ◽  
Vol 35 (03) ◽  
pp. 304-310
Author(s):  
Temeka Zore ◽  
Erica Wang
Keyword(s):  
Perinatal Outcomes ◽  
The United States ◽  
Autism Spectrum ◽  
Reproductive Age ◽  
Childhood Development ◽  
Fertility Treatment ◽  
Comprehensive Overview ◽  
Vitro Fertilization

AbstractInfertility affects 11% of reproductive-age women in the United States and the number of live births from infertility treatment, both in vitro fertilization (IVF) and non-IVF fertility treatment (NIFT), continues to rise. Given this trend, the perinatal and childhood outcomes of children conceived with assisted reproduction are of critical importance. We provide a comprehensive overview of the current literature, consisting primarily of observational cohort studies focused on IVF children. The outcomes of interest include (1) perinatal outcomes of low birth weight and prematurity; (2) congenital birth defects; (3) childhood development to encompass autism spectrum disorders, development, and school functioning; (4) growth and puberty: and (5) childhood cancer. Overall, these data appear to be reassuring; however, further studies are needed to clarify the role of underlying parental infertility and to focus on NIFT conceptions. There remains a paucity of long-term data for these children as they progress to adulthood and long-term prospective registries will be the key to answering these questions.

How Does the Inclusion of Twins Conceived via Fertility Treatments Influence the Results of Twin Studies?

2012 ◽  
Vol 15 (6) ◽  
pp. 746-752 ◽  
Author(s):  
S. Alexandra Burt ◽  
Kelly L. Klump
Keyword(s):  
Twin Studies ◽  
The United States ◽  
Fertility Treatment ◽  
State University ◽  
Behavioral Differences ◽  
Vitro Fertilization ◽  
Fertility Treatments ◽  
Control And Prevention ◽  
Twin Families

Rates of twinning have risen dramatically over the last 30 years, from 1 in 53 births in 1980 to 1 in 30 births in 2009 (Martin et al. (January 2012). Three decades of twin births in the United States, 1980–2009. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Health Statistics). This increase is largely attributable to increases in the use of fertility treatments (i.e., ovulation induction and in vitro fertilization) combined with delays in parenthood. Although this increase means that more twins are available for recruitment into twin studies, it also has potential consequences for the heritability estimates obtained in these studies. This study sought to evaluate this possibility, making use of the ongoing Michigan Twins Project (N = 7,261 families with twins aged 3–17 years), an arm of the Michigan State University Twin Registry. Results revealed that, on average, twins conceived via fertility treatments had lower rates of behavior problems than those conceived naturally, although these behavioral differences could be explained largely by demographic and socio-economic differences across the two types of twin families. Twin similarity did not meaningfully differ across fertility treatment status. We thus conclude that estimates of genetic and environmental influences obtained from twin studies over the last 10–15 years are more or less unaffected by the inclusion of twins conceived via fertility treatments in their samples.

Peculiarities of pregnancy and delivery course in women after the application of assisted reproductive technologies against obesity (Based on the retrospective analysis)

2018 ◽  
pp. 122-126
Author(s):  
I.A. Zhabchenko ◽  
◽  
O.R. Sudmak ◽  
Keyword(s):  
In Vitro Fertilization ◽  
Pregnant Women ◽  
Retrospective Analysis ◽  
Perinatal Outcomes ◽  
Reproductive Technologies ◽  
Ischemic Lesion ◽  
Vitro Fertilization ◽  
Pregnancy And Delivery

The objective: to study the structure and frequency of complications of pregnancy, deliveries and perinatal outcomes in three groups of women: women with infertility and obesity, treated by application of in vitro fertilization (hereinafter IVF), pregnant women after IVF application with normal body weight, and pregnant women on the background of obesity which did not have an infertility in past history. Materials and methods. A retrospective analysis of 221 case histories of pregnancies and labors in women who were treated and gave birth in the Pregnancy and delivery pathology Department of SI «Institute of Pediatrics, Obstetrics and Gynecology named after Acad. O. M. Lukyanova of NAMS of Ukraine» for 2012 – 2016 years was carried out. Results. The overwhelming majority of pregnant women after IVF on the background of obesity are primaparas, who have a complicated obstetric history, hormonal changes in the form of progesterone deficiency predominantly and chronic inflammatory processes. Pregnancy with a combination of infertility, treated by the means of IVF application, and obesity, in most cases is accompanied by a long-term threat of termination of pregnancy (48.8%), threatening preterm deliveries (56%), placental dysfunction (41.5%), premature rupture of the amniotic membranes (41.5%), other problems during pregnancy, at the same time, every second woman (58.5%) had a combination of several complications, and required a long-term and repeated inpatient treatment (53.7%). The specific gravity of surgical delivery was 90%, and 16.2% of such deliveries were complicated by pathological blood loss. The number of preterm deliveries was 17.1%, with perinatal losses up to 11.3‰. Among full-term newborns 21.3% of newborns had malnutrition of the I degree and 17% of them had hypoxic-ischemic lesion of CNS. Conclusion. The course of pregnancy, delivery and the postpartum period in the studied contingent of women has a significant frequency of complications, mainly the coinciding ones, which affects on the consequences of perinatal outcomes and requires further study of this problem and the development of differentiated algorithms for antenatal observation. Key words: pregnancy, obesity, in vitro fertilization, complications, delivery, newborn.

scholarly journals Sex-specific effects of in vitro fertilization on adult metabolic phenotypes and hepatic transcriptomic and proteomic pathways in mouse

2020 ◽  
Author(s):  
Laren Narapareddy ◽  
Eric A. Rhon-Calderon ◽  
Lisa A. Vrooman ◽  
Josue Baeza ◽  
Duy K. Nguyen ◽  
...  
Keyword(s):  
Regulatory Element ◽  
Perinatal Outcomes ◽  
Vitro Fertilization ◽  
Specific Effects ◽  
Cholesterol Levels ◽  
Element Binding Protein ◽  
Fat Composition ◽  
Sterol Regulatory Element

AbstractAlthough in vitro fertilization (IVF) is associated with adverse perinatal outcomes, an increasing concern is the long-term health implications. We augmented our IVF mouse model to longitudinally investigate cardiometabolic outcomes in offspring from optimal neonatal litter sizes. We found that IVF-conceived females had higher body weight and cholesterol levels compared to naturally-conceived females, whereas IVF-conceived males had higher levels of triglycerides and insulin, and increased body fat composition. Through transcriptomics and proteomics of adult liver, we identified sexually-dimorphic dysregulation of the sterol regulatory element binding protein (SREBP) pathways that are associated with the sex-specfic phenotypes. We also found that global loss of DNA methylation in placenta was linked to higher cholesterol levels in IVF-conceived females. Our findings indicate that IVF procedures have long-lasting sex-specific effects on metabolic health of offspring and lay the foundation to utilize the placenta as a predictor of long-term outcomes.

scholarly journals Treatment of vulvovaginal candidiasis in preparation programs for in vitro fertilization

2021 ◽  
pp. 77-83
Author(s):  
A. Yu. Romanov ◽  
A. G. Syrkasheva ◽  
I. V. Kuznetsova
Keyword(s):  
Topical Therapy ◽  
Perinatal Outcomes ◽  
First Trimester ◽  
Vulvovaginal Candidiasis ◽  
Reproductive Age ◽  
Preparation Programs ◽  
Vitro Fertilization ◽  
History Of ◽  
Adverse Perinatal Outcomes

Vulvovaginal candidiasis (VVC) is considered as the second most common cause of vaginitis after bacterial vaginosis. About three quarters of women of reproductive age have a history of at least one episode of VVC, and about a half of women have two or more episodes. Candida albicans is responsible for85% to 90% of vulvovaginal candidiasis. There are uncomplicated and complicated forms of VVC. Uncomplicated forms are not severe cases caused by C. albicans. Complicated forms are cases caused by other Candida species, severe cases, cases that develop during pregnancy or associated with other diseases such as diabetes mellitus or immunosuppressive conditions. Reccurent cases are also complicated ones. Therapeutic schemes should depend on the form of the VVC. Short-term topical therapy or a single oral dose are effective in 90% of uncomplicated cases. Complicated forms of VVC require longer treatment. Oral fluconazole can be administered three times with a break of 72 hours. Topical azoles can be administered daily for at least 1 week. So, sertaconazole in the form of suppositories is used once intravaginally. The data on the use of probiotics in the treatment of VVC today are contradictory and heterogeneous. Treatment of VVC during pregnancy, especially in the first trimester, may be associated with adverse perinatal outcomes. On the other hand, during pregnancy, VVC can be more severe than in non-pregnant women, especially in the second half of pregnancy. In addition, the risk of transmission to a newborn is about 50%. Thus, the identification and treatment of VVC is one of the important tasks in pregnancy planning, including assisted reproduction.

Health Care-Related Economic Burden of Polycystic Ovary Syndrome in the United States: Pregnancy-Related and Long-Term Health Consequences

2021 ◽  
Author(s):  
Carrie Riestenberg ◽  
Anika Jagasia ◽  
Daniela Markovic ◽  
Richard P Buyalos ◽  
Ricardo Azziz
Keyword(s):  
United States ◽  
Polycystic Ovary Syndrome ◽  
Economic Burden ◽  
Polycystic Ovary ◽  
The United States ◽  
Reproductive Age ◽  
Cochrane Library ◽  
Control Group ◽  
Ovary Syndrome

Abstract Context Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of reproductive-aged women, affecting approximately 5-20% of women of reproductive age. A previous estimate noted that the economic burden of PCOS approximates $3.7 billion annually in 2020 USD when considering only the costs of the initial diagnosis and of reproductive endocrine morbidities, not considering the costs of pregnancy-related and long-term morbidities. Objective To estimate the excess prevalence and economic burden of pregnancy-related and long-term health morbidities attributable to PCOS. Data Sources PubMed, EmBase and Cochrane Library. Study Selection Studies in which the diagnosis of PCOS was consistent with the Rotterdam, National Institutes of Health (NIH), or Androgen Excess & PCOS (AE-PCOS) Society criteria, or that used electronic medical record diagnosis codes, or diagnosis based on histopathologic sampling were eligible for inclusion. Studies that included an outcome of interest and a control group of non-PCOS patients who were matched or controlled for body mass index (BMI) were included. Data Extraction Two investigators working independently extracted data on study characteristics and outcomes. Data Synthesis Data was pooled using random-effects meta-analysis. The I 2statistic was used to assess inter-study heterogeneity. The quality of selected studies was assessed using the Newcastle-Ottawa Scale. Results The additional total healthcare-related economic burden due to pregnancy-related and long-term morbidities associated with PCOS in the United States is estimated to be $4.3 billion annually in 2020 USD. Conclusions Together with our prior analysis, the economic burden of PCOS is estimated at $8 billion annually in 2020 USD.

A Baby at All Costs? Exploring the Use and Provision of Unproven Adjuvant Treatments in the Context of IVF

2021 ◽  
Author(s):  
Georgina L. Jones ◽  
Victoria Lang ◽  
Nicky Hudson
Keyword(s):  
Reproductive Technologies ◽  
Patient Survey ◽  
Fertility Treatment ◽  
Vitro Fertilization ◽  
The Past ◽  
The United Kingdom ◽  
Wide Range ◽  
National Patient ◽  
Psychosocial Perspective

AbstractThe year 2018 marked 40 years since the birth of Louise Brown, the first baby born as a result of pioneering in vitro fertilization (IVF) treatment. Since then, advances have seen a wide range of reproductive technologies emerge into clinical practice, including adjuvant treatments often referred to as IVF “add-ons.” However, these “optional extras” have faced growing criticism, especially when they have often come at additional financial cost to the patient and have little evidence supporting their efficacy to improve pregnancy or birth rates. Despite this, according to the latest national patient survey by the Human Fertilisation and Embryology Authority, three quarters of patients who had fertility treatment in the United Kingdom in the past two years had at least one type of treatment add-on highlighting the growing demand for these interventions. This article uses a psychosocial perspective to consider the motivations behind patient and clinician behavior along with the wider societal and economic factors that may be impacting upon the increase in the use of adjuvant treatments in fertility clinics more widely. It suggests the reasons fertility patients use unproven “optional extras” are complex, with interpersonal, psychological, and social factors intertwining to generate an increase in the use of IVF add-ons.

Achieving pregnancy at a late reproductive age in a patient with a history of multiple failed in vitro fertilization attempts

2021 ◽  
Vol 7_2021 ◽  
pp. 202-209
Author(s):  
Kirienko K.V. Kirienko ◽  
Osina E.A. Osina ◽  
Apryshko V.P. Apryshko ◽  
Voloshanenko V.V. Voloshanenko V ◽  
Yakovenko S.A. Yakovenko S ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Reproductive Age ◽  
Vitro Fertilization ◽  
History Of

Fertility Treatments and the Risk of Preterm Birth Among Women with Subfertility: A Linked-Data Retrospective Cohort Study

2021 ◽  
Author(s):  
Jessica N Sanders ◽  
Sara E Simonsen ◽  
Christina A Porucznik ◽  
Ahmad O Hammoud ◽  
Ken Smith ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Birth ◽  
In Vitro Fertilization ◽  
Retrospective Cohort ◽  
Fetal Death ◽  
Perinatal Outcomes ◽  
Birth Certificates ◽  
Vitro Fertilization ◽  
Fertility Treatments

Abstract Background: In vitro fertilization (IVF) births contribute to a considerable proportion of preterm birth (PTB) each year. However, there is no formal surveillance of adverse perinatal outcomes for less invasive fertility treatments. The study objective was to determine the effect of fertility treatment (in vitro fertilization, intrauterine insemination, usually with ovulation drugs (IUI), or ovulation drugs alone) on preterm birth, compared to no treatment in subfertile women.Methods: The Fertility Experiences Study (FES) is a retrospective cohort study conducted at the University of Utah between April 2010 and September 2012. Women with a history of primary subfertility self-reported treatment data via survey and interviews. Participant data were linked to birth certificates and fetal death records to asses for perinatal outcomes, particularly preterm birth.Results: A total 487 birth certificates and 3 fetal death records were linked as first births for study participants who completed questionnaires. Among linked births, 19% had a PTB. After adjustment for maternal age, paternal age, maternal education, annual income, religious affiliation, female or male fertility diagnosis, and duration of subfertility, the odds ratios and 95% confidence intervals (CI) for PTB were 2.17 (CI: 0.99, 4.75) for births conceived using ovulation drugs, 3.17 (CI: 1.4, 7.19) for neonates conceived using IUI and 4.24 (CI: 2.05, 8.77) for neonates conceived by IVF, compared to women with subfertility who used no treatment during the month of conception. A reported diagnosis of female factor infertility increased the adjusted odds of having a PTB 2.99 (CI: 1.5, 5.97). Duration of pregnancy attempt was not independently associated with PTB. In restricting analyses to singleton gestation, odds ratios remained elevated but were not significant for any type of treatment.Conclusion: IVF, IUI, and ovulation drugs were all associated with a higher incidence of preterm birth and low birth weight, predominantly related to multiple gestation births.

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