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Arch Gynecol Obstet. 2017 Feb;295(2):285-301. doi: 10.1007/s00404-016-4250-3. Epub 2016 Nov 28.

Worldwide prevalence of adverse pregnancy outcomes among singleton pregnancies after in vitro fertilization/intracytoplasmic sperm injection: a systematic review and meta-analysis.

Author information

1
Information Management Division, Hunan Provincial Maternal and Child Health Care Hospital, 53 Xiangchun Road, Changsha, 410008, Hunan, China. qinjiabi123@163.com.
2
Division of Medical Genetics, Hunan Provincial Maternal and Child Health Care Hospital, 53 Xiangchun Road, Changsha, 410008, Hunan, China. qinjiabi123@163.com.
3
Division of Medical Genetics, Hunan Provincial Maternal and Child Health Care Hospital, 53 Xiangchun Road, Changsha, 410008, Hunan, China.
4
Enrollment and Employment Office, Hunan University of Traditional Chinese Medicine, Changsha, Hunan, China.
5
Reproductive Medicine Center, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China.
6
Maternity Department, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China.
7
Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, China.
8
Division of Medical Genetics, Hunan Provincial Maternal and Child Health Care Hospital, 53 Xiangchun Road, Changsha, 410008, Hunan, China. wangh1234@hotmail.com.

Abstract

PURPOSE:

The worldwide prevalence of adverse pregnancy outcomes (APOs) in singleton pregnancies after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) is suggested to vary; however, a complete overview is missing. The aim of this review is to estimate the worldwide prevalence of APOs associated with IVF/ICSI singleton pregnancies.

METHODS:

PubMed, Google Scholar, Cochrane Libraries, and Chinese databases were searched for studies assessing APOs among IVF/ICSI singleton births through March 2016. The prevalence estimates were summarized and analyzed by meta-analysis.

RESULTS:

Fifty-two cohort studies, with 181,741 IVF/ICSI singleton births and 4,636,508 spontaneously conceived singleton births, were selected for analysis. Among IVF/ICSI singleton pregnancies, pooled estimates were 10.9% [95% confidence interval (CI) 10.0-11.8] for preterm birth, 2.4% (95% CI 1.9-3.0) for very preterm birth, 8.7% (95% CI 7.4-10.2) for low birth weight, 2.0% (95% CI 1.5-2.6) for very low birth weight, 7.1% (95% CI 5.5-9.2) for small for gestational age, 1.1% (95% CI 0.9-1.3) for perinatal mortality, and 5.7% (95% CI 4.7-6.9) for congenital malformations. The IVF/ICSI singleton pregnancies have higher prevalence of APOs compared with those conceived naturally (all P = 0.000). Significant differences in different continents, countries, income groups, and type of assisted conception were found.

CONCLUSIONS:

The IVF/ICSI singleton pregnancies are at a higher prevalence of adverse perinatal outcomes compared with those conceived naturally. Important geographical differences were found. Yet, population-wide prospective APO registries covering the entire world population for IVF/ICSI pregnancies are needed to determine the exact perinatal prevalence.

KEYWORDS:

Adverse pregnancy outcomes; In vitro fertilization; Intracytoplasmic sperm injection; Meta-analysis; Prevalence estimates

PMID:
27896474
DOI:
10.1007/s00404-016-4250-3
[Indexed for MEDLINE]

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