AI Summary & Key Takeaways
AI InsightPhysicians should consider these risks while counselling patients.
📌 3 Key Takeaways
Abstract
Objective: Pregnancies after in vitro fertilization (IVF) are associated with a less favorable outcome compared to natural conception as consistently shown in various studies. However, etiologic factors behind this issue remain to be elucidated. We aimed to demonstrate whether the etiology of infertility has a role on poor pregnancy outcomes in IVF pregnancies. Methods: In this retrospective case control study; IVF and spontaneous singleton pregnancies were investigated. The infertile patients were divided into six groups according to the etiology of their infertility (anovulation, male factor, tubal factor, endometriosis, unexplained infertility and poor ovarian reserve). The incidence of preeclampsia, gestational diabetes mellitus, intrahepatic cholestasis of pregnancy, preterm birth and birth weight discrepancies was examined between the groups and subgroups. After adjusting the confounding variables for each infertility subgroup such as demographic data, embryo stage in transfer (blastocyst against cleavage stage) and fresh and frozen embryo transfer status, the effect on pregnancy outcomes was investigated using multinomial logistic regression analysis. Results: The study included 934 patients in the IVF group and 1009 patients in the control group. While adverse pregnancy outcomes were more frequent in the general infertility group in comparison to the control group, after elimination of the confounding variables, the direct effect of the etiology of infertility on these outcomes could not be shown. Conclusion: In the IVF pregnancies, most of the increased risk of poor pregnancy outcomes appeared to be explained by maternal characteristics (such as age, body mass index) and by treatment protocols rather than infertility etiology. Physicians should consider these risks while counselling patients.
Özet
Amaç: ‹n vitro fertilizasyon (IVF) sonras› gebelikler, çeflitli çal›flmalarda tutarl› flekilde gösterildi¤i üzere do¤al konsepsiyona k›- yasla daha az olumlu sonuç ile iliflkilidir. Ancak bu sorunun ard›ndaki etiyolojik faktörler henüz aç›klanamam›flt›r. Çal›flmam›zda, infertilite etiyolojisinin IVF gebeliklerdeki kötü gebelik sonuçlar› üzerinde bir rolü olup olmad›¤›n› göstermeyi amaçlad›k. Yöntem: Bu retrospektif olgu kontrol çal›flmas›nda IVF ve spontane tekil gebelikler incelendi. ‹nfertil hastalar, infertilite etiyolojisine göre alt› gruba ayr›ld› (anovülasyon, erkek faktörü, tubal faktör, endometriyoz, aç›klanamayan infertilite ve düflük over rezervi). Preeklampsi, gestasyonel diabetes mellitus, gebeli¤in intrahepatik kolestaz›, preterm do¤um ve do¤um a¤›rl›¤› uyuflmazl›klar›- n›n insidans› gruplar ve alt gruplar aras›nda incelendi. Her infertilite alt grubu için demografik veriler, transferde embriyo aflamas› (blastokiste karfl› klevaj aflamas›) ve taze dondurulmufl embriyo transfer durumu gibi kar›fl›kl›¤a neden olan de¤iflkenler düzeltildikten sonra, multinomiyal lojistik regresyon analizi kullan›larak gebelik sonuçlar› üzerindeki etki araflt›r›ld›. Bulgular: Çal›flmaya IVF grubunda 934 hasta ve kontrol grubunda 1009 hasta dahil edildi. Advers gebelik sonuçlar› kontrol grubuna k›yasla genel infertilite grubunda daha s›kken, kar›flt›r›c› de¤iflkenlerin ç›kar›lmas› sonras›nda infertilite etiyolojisinin bu sonuçlar üzerindeki do¤rudan etkisi gösterilememifltir. Sonuç: IVF gebeliklerde, artm›fl kötü gebelik sonucu risklerinin ço¤unun maternal özelliklerle (örne¤in yafl ve vücut kitle indeksi) ve infertilite etiyolojisinden ziyade tedavi protokolleriyle aç›klanabildi¤ i görülmektedir. Hekimler hastalara dan›flmanl›k verirken bu riskleri dikkate almal›d›r.