First trimester pregnancy loss after fresh and frozen in vitro fertilization cycles

The magnitudes of risk for early pregnancy loss after in vitro fertilization for all infertility diagnoses were small. The risks were similar when transferring similar quality embryos in fresh or frozen cycles.

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Authors

Heather Hipp, M.D., Sara Crawford, Ph.D., Jennifer F. Kawwass, M.D., Jeani Chang, M.P.H., Dmitry M. Kissin, M.D., M.P.H., Denise J. Jamieson, M.D., M.P.H.

Volume 105, Issue 3, Pages 722-728

Abstract

Objective:

To characterize risks for early pregnancy loss after fresh and frozen IVF cycles and to investigate whether risk is modified by infertility diagnoses or transfer of embryos in fresh versus frozen cycles.

Design:

Retrospective cohort study using data from the National Assisted Reproductive Technology (ART) Surveillance System.

Setting:

U.S. fertility centers.

Patient(s):

Clinical pregnancies achieved with fresh and frozen IVF cycles between 2007 and 2012 (N = 249,630).

Intervention(s):

None.

Main Outcome Measure(s):

First trimester pregnancy loss.

Result(s):

A diagnosis of uterine factor was associated with an increased risk of loss in women aged 40 years and younger (<30 years: adjusted risk ratio (aRR) = 1.24, 95% confidence interval (CI) 1.04–1.48; 30–34 years: aRR = 1.27, 95% CI 1.17–1.38; 35–37 years: aRR = 1.12, 95% CI 1.03–1.21; 38–40 years: aRR = 1.08, 95% CI 1.01–1.17). There was an increased risk of loss in women with diminished ovarian reserve aged 30–34 years (aRR = 1.08, 95% CI 1.01–1.15) and in women with ovulatory dysfunction younger than 35 years (<30 years: aRR = 1.12, 95% CI 1.05–1.19; 30–34 years: aRR = 1.07, 95% CI 1.02–1.13). There was an increased risk of loss after frozen ETs versus fresh among women younger than 38 years, but this remained significant in the subanalysis of similar quality embryos only in women younger than 30 years (aRR = 1.16, 95% CI 1.04–1.32). Conclusion(s):

Uterine factor had the largest increased risk of loss among infertility diagnoses, although the magnitudes of all risks were small. When transferring embryos of similar quality, the risks of loss were similar between fresh and frozen cycles.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)02088-9/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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