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Preterm birth: is it the patient or the process?

      There is an ongoing debate about whether assisted reproductive technology (ART) procedures themselves are responsible for undesirable pregnancy outcomes or if these outcomes are related to the underlying patient diagnoses that necessitate ART in the first place. The study by Libby et al. (
      • Libby V.
      • DeVilbiss E.
      • Chung M.
      • Dilday E.
      • Babayev S.N.
      • Weinerman R.
      • et al.
      Obstetric outcomes in pregnancies resulting from In Vitro Fertilization (IVF) are not different in fertile, sterilized patients compared to infertile women: A Society for Assisted Reproductive Technology (SART) database analysis.
      ) was designed with the goal of helping answer this question. The underlying hypothesis of their study was predicated on the idea that comparing women without true infertility undergoing ART with those with infertility would help resolve this debate. In doing so, they hoped to tease out whether obstetric outcomes were related to the manipulation of gametes and/or the artificial hormonal environment created as part of ART and, if there was such a relationship, what was the degree of the relationship.
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