Objective
To study the perinatal outcomes between singleton live births achieved with the use
of commissioned versus spontaneously conceived embryos carried by the same gestational
surrogate.
Design
Retrospective cohort study.
Setting
Academic in vitro fertilization center.
Patient(s)
Gestational surrogate.
Intervention(s)
None.
Main Outcome Measure(s)
Pregnancy outcome, gestational age at birth, birth weight, perinatal complications.
Result(s)
We identified 124 gestational surrogates who achieved a total of 494 pregnancies.
Pregnancy outcomes for surrogate and spontaneous pregnancies were significantly different
(
P<.001), with surrogate pregnancies more likely to result in twin pregnancies: 33% vs.
1%. Miscarriage and ectopic rates were similar. Of these pregnancies, there were 352
singleton live births: 103 achieved from commissioned embryos and 249 conceived spontaneously.
Surrogate births had lower mean gestational age at delivery (38.8 ± 2.1 vs. 39.7 ±
1.4), higher rates of preterm birth (10.7% vs. 3.1%), and higher rates of low birth
weight (7.8% vs. 2.4%). Neonates from surrogacy had birth weights that were, on average,
105 g lower. Surrogate births had significantly higher obstetrical complications,
including gestational diabetes, hypertension, use of amniocentesis, placenta previa,
antibiotic requirement during labor, and cesarean section.
Conclusion(s)
Neonates born from commissioned embryos and carried by gestational surrogates have
increased adverse perinatal outcomes, including preterm birth, low birth weight, hypertension,
maternal gestational diabetes, and placenta previa, compared with singletons conceived
spontaneously and carried by the same woman. Our data suggest that assisted reproductive
procedures may potentially affect embryo quality and that its negative impact can
not be overcome even with a proven healthy uterine environment.
Key Words
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References
- Perinatal outcome among singleton infants conceived through assisted reproductive technology in the United States.Obstet Gynecol. 2004; 103: 1144-1153
- Low and very low birth weight in infants conceived with use of assisted reproductive technology.N Engl J Med. 2002; 346: 731-737
- Pregnancy outcomes in very advanced maternal age pregnancies: the impact of assisted reproductive technology.Fertil Steril. 2015; 103: 76-80
- Assisted reproductive technology and pregnancy outcome.Obstet Gynecol. 2005; 106: 1039-1045
- Factors influencing adverse perinatal outcomes in pregnancies achieved through use of in vitro fertilization.Fertil Steril. 2006; 86: 1634-1641
- The fetal and infant origins of adult disease.BMJ. 1990; 301: 1111
- Maternal undernutrition during the preimplantation period of rat development causes blastocyst abnormalities and programming of postnatal hypertension.Development. 2000; 127: 4195-4202
- Advanced maternal age and adverse perinatal outcome.Obstet Gynecol. 2004; 104: 727-733
- Does oocyte donation compared with autologous oocyte IVF pregnancies have a higher risk of preeclampsia?.Reprod Biomed Online. 2017; 34: 11-18
- Adverse obstetric outcomes in pregnancies resulting from oocyte donation: a retrospective cohort case study in Sweden.BMC Pregnancy Childbirth. 2015; 15: 247
- Neonatal outcomes in pregnancies resulting from oocyte donation: a cohort study in Sweden.BMC Pediatr. 2016; 16: 170
- Obstetric and neonatal complications in pregnancies conceived after oocyte donation: a systematic review and meta-analysis.Bjog. 2017; 124: 561-572
- Pregnancy in the sixth decade of life: obstetric outcomes in women of advanced reproductive age.JAMA. 2002; 288: 2320-2323
- Hormonal induction of endometrial receptivity.Fertil Steril. 2011; 96: 530-535
- Fifteen years experience with an in-vitro fertilization surrogate gestational pregnancy programme.Hum Reprod. 2000; 15: 1075-1078
- Outcome and follow-up of children born after IVF-surrogacy.Hum Reprod Update. 2001; 7: 23-27
- Perinatal outcome after in-vitro fertilization-surrogacy.Hum Reprod. 1999; 14: 671-676
- Obstetrical complications in gestational carrier pregnancies.Fertil Steril. 2005; 83: 749-754
- Magnitude of maternal morbidity during labor and delivery: United States, 1993–1997.Am J Public Health. 2003; 93: 631-634
Wiggins DA, Main E. Outcomes of pregnancies achieved by donor egg in vitro fertilization—a comparison with standard in vitro fertilization pregnancies. In: Am J Obstet Gynecol. Vol 192. United States2005:2002–6; discussion 2006–2008.
- Public reporting of assisted reproductive technology outcomes: past, present, and future.Am J Obstet Gynecol. 2015; 212: 157-162
- Perinatal outcomes in singletons following in vitro fertilization: a meta-analysis.Obstet Gynecol. 2004; 103: 551-563
- Assisted reproductive technology surveillance—United States, 2014.MMWR Surveill Summ. 2017; 66: 1-24
- Effects of culture conditions on IVF outcome.Eur J Obstet Gynecol Reprod Biol. 2004; 115: S72-S76
- Does the type of culture medium used influence birthweight of children born after IVF?.Hum Reprod. 2015; 30: 530-542
- Do ARTs affect the incidence of monozygotic twinning?.Hum Reprod. 2016; 31: 2435-2441
- The type of culture medium and the duration of in vitro culture do not influence birthweight of ART singletons.Hum Reprod. 2015; 30: 20-27
- In vitro fertilization (IVF) in mammals: epigenetic and developmental alterations. Scientific and bioethical implications for IVF in humans.Biol Res. 2015; 48: 68
- Establishment of the paternal methylation imprint of the human H19 and MEST/PEG1 genes during spermatogenesis.Hum Mol Genet. 2000; 9: 2183-2187
- Large offspring syndrome in cattle and sheep.Rev Reprod. 1998; 3: 155-163
- Large offspring syndrome and other consequences of ruminant embryo culture in vitro: relevance to blastocyst culture in human ART.Hum Fertil (Camb). 2000; 3: 238-246
- A random-effects model for cycle viability in fertility studies.J Am Stat Assoc. 1996; 91: 1413-1422
- Ovarian stimulation protocols for IVF: is more better than less?.Reprod Biomed Online. 2017; 34: 345-353
- Gonadotropin therapy: a 20th century relic.Fertil Steril. 2012; 97: 813-818
- Association of number of retrieved oocytes with live birth rate and birth weight: an analysis of 231,815 cycles of in vitro fertilization.Fertil Steril. 2015; 103: 931-938.e932
- Does subfertility explain the risk of poor perinatal outcome after IVF and ovarian hyperstimulation?.Hum Reprod. 2006; 21: 3228-3234
- Why do singletons conceived after assisted reproduction technology have adverse perinatal outcome? Systematic review and meta-analysis.Hum Reprod Update. 2013; 19: 87-104
- Perinatal outcomes of singleton siblings: the effects of maternal fertility status and ART treatment.J Assist Reprod Genet. 2016; 33: 1203-1213
- Do delayed childbearers face increased risks of adverse pregnancy outcomes after the first birth?.Obstet Gynecol. 1993; 81: 512-516
- Perinatal outcome of singleton siblings born after assisted reproductive technology and spontaneous conception: Danish national sibling-cohort study.Fertil Steril. 2011; 95: 959-963
- Effects of technology or maternal factors on perinatal outcome after assisted fertilisation: a population-based cohort study.Lancet. 2008; 372: 737-743
Article Info
Publication History
Accepted:
September 13,
2017
Received in revised form:
September 12,
2017
Received:
June 20,
2017
Footnotes
I.W. has nothing to disclose. R.H. has nothing to disclose. M.L. has nothing to disclose. J.H. has nothing to disclose. S.A.I. has nothing to disclose. L.K.M. has nothing to disclose. R.J.P. has nothing to disclose. K.C. has nothing to disclose.
Identification
Copyright
©2017 American Society for Reproductive Medicine, Published by Elsevier Inc.
