October 31, 2005

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

SOURCE: Obstetrics & Gynecology, November 2005.