The influence of assisted reproductive technologies on obstetric and perinatal outcomes: the chicken, the egg, or both?

      Safety and efficacy have been the overriding concerns for the assisted reproductive technologies (ART) since their inception over 40 years ago. Adverse obstetric and perinatal outcomes were recognized as inherent risks early on, but much of this excess risk stemmed from the high multiple pregnancy rates attributed to ART. With the advent of successful single embryo transfer (SET), that risk was substantially mitigated, and with significant improvements in pregnancy rates with SET, largely due to advances in the laboratory, it now is feasible to contemporaneously assess the true risk of ART more precisely with smaller populations of patients in a shorter timeframe. An unresolved question is how much of the recognized additional maternal and neonatal risk is due to the technology itself vs. the underlying risk conferred with the diagnosis of infertility.
      To read this article in full you will need to make a payment


        • Ganer Herman H.
        • Mizrachi Y.
        • Shevach Alon A.
        • Farhadian Y.
        • Gluck O.
        • Bar J.
        • et al.
        Obstetric and perinatal outcomes of in vitro fertilization and natural pregnancies in the same mother.
        Fertil Steril. 2021; 115: 940-946
        • Vermey B.G.
        • Buchanan A.
        • Chambers G.M.
        • Kolibianakis E.M.
        • Bosdou J.
        • Chapman M.G.
        • et al.
        Are singleton pregnancies after assisted reproduction technology (ART) associated with a higher risk of placental anomalies compared with non-ART singleton pregnancies? A systematic review and meta-analysis.
        BJOG. 2019; 126: 209-218
        • Pisarska M.D.
        • Chan J.L.
        • Lawrenson K.
        • Gonzalez T.L.
        • Wang E.T.
        Genetics and epigenetics of infertility and treatments on outcomes.
        J Clin Endocrinol Metab. 2019; 104: 1871-1886
        • Luke B.
        • Gopal D.
        • Cabral H.
        • Diop H.
        • Stern J.E.
        Perinatal outcomes of singleton siblings: the effects of changing maternal fertility status.
        J Assist Reprod Genet. 2016; 33: 1203-1213
        • Valenzuela-Alcaraz B.
        • Serafini A.
        • Sepulveda-Martinez A.
        • Casals G.
        • Rodriguez-Lopez M.
        • Garcia-Otero L.
        • et al.
        Postnatal persistence of fetal cardiovascular remodelling associated with assisted reproductive technologies: a cohort study.
        BJOG. 2019; 126: 291-298

      Linked Article