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STUDY QUESTION Do obstetric and perinatal complications vary according to different blastocyst developmental parameters after frozen-thawed single-blastocyst transfer (SBT) cycles? SUMMARY ANSWER Pregnancies following the transfer of a blastocyst with a grade C trophectoderm (TE) were associated with an increased risk of placenta previa compared to those with a blastocyst of grade A TE. WHAT IS KNOWN ALREADY Existing studies investigating the effect of blastocyst morphology grades on birth outcomes have mostly focused on fetal growth and have produced conflicting results, while the risk of obstetric complications has rarely been reported. Additionally, growing evidence has suggested that the appearance of TE cells could serve as the most important parameter for predicting implantation and live birth. Given that the TE ultimately develops into the placenta, it is plausible that this independent predictor may also impact placentation. STUDY DESIGN, SIZE, DURATION This retrospective cohort study at a tertiary-care academic medical center included 6018 singleton deliveries after frozen-thawed SBT cycles between January 2017 and December 2021. PARTICIPANTS/MATERIALS, SETTING, METHODS Singleton pregnancies were grouped into two groups according to blastocyst developmental stage (Days 5 and 6), four groups according to embryo expansion (Stages 3, 4, 5, and 6), three groups according to inner cell mass (ICM) quality (A, B, and C), and three groups according to TE quality (A, B, and C). The main outcomes included pregnancy-induced hypertension, preeclampsia, gestational diabetes mellitus, preterm premature rupture of membrane, placenta previa, placental abruption, placenta accreta, postpartum hemorrhage, preterm birth, low birth weight, small for gestational age, and birth defects. Multivariate logistic regressions were performed to evaluate the effect of blastocyst developmental stage, embryo expansion stage, ICM grade, and TE grade on measured outcomes adjusting for potential confounders. MAIN RESULTS AND THE ROLE OF CHANCE No association was found between blastocyst developmental stage and obstetric or perinatal outcomes both before and after adjusting for potential confounders, and similar results were found with regard to embryo expansion stage and ICM grade. Meanwhile, the incidence of placenta previa derived from a blastocyst with TE of grade C was higher compared with those derived from a blastocyst with TE of grade A (1.7%, 2.4%, and 4.0% for A, B, and C, respectively, P  =   0.001 for all comparisons). After adjusting for potential covariates, TE grade C blastocysts had 2.81 times the likelihood of resulting in placenta previa compared to TE grade A blastocysts (adjusted odds ratio 2.81, 95% CI 1.11–7.09). No statistically significant differences were detected between any other measured outcomes and TE grades both before or after adjustment. LIMITATIONS, REASONS FOR CAUTION The study is limited by its retrospective, single-center design. Additionally, although the sample size was relatively large for the study group, the sample size for certain subgroups was relatively small and lacked adequate power, particularly the ICM grade C group. Therefore, these results should be interpreted with caution. WIDER IMPLICATIONS OF THE FINDINGS The study extends our knowledge of the potential downstream effect of TE grade on placental abnormalities. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the National Key Research and Development Program of China (2023YFC2705500, 2023YFC2705501, 2023YFC2705505, 2019YFA0802604); National Natural Science Foundation of China (82130046, 82320108009, 82371660, 32300710); Shanghai leading talent program, Innovative research team of high-level local universities in Shanghai (SHSMU-ZLCX20210201, SHSMU-ZLCX20210200, SHSMU-ZLCX20180401), Shanghai Jiaotong University School of Medicine Affiliated Renji Hospital Clinical Research Innovation Cultivation Fund Program (RJPY-DZX-003), Science and Technology Commission of Shanghai Municipality (23Y11901400), Shanghai's Top Priority Research Center Construction Project (2023ZZ02002), and Three-Year Action Plan for Strengthening the Construction of the Public Health System in Shanghai (GWVI-11.1-36). The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

Study Question: Are transfer day, developmental stage and morphology of the competent blastocyst in pregnancies leading to live birth associated with preterm birth, birthweight, length at birth and sex of the child?Summary Answer: A high score in blastocyst developmental stage and in trophectoderm (TE) showed a significant association with the sex of the child, while no other associations with obstetric outcomes were observed.What Is Known Already: The association between blastocyst assessment scores and obstetric outcomes have been reported in small single-center studies and the results are conflicting.Study Design, Size, Duration: Multicenter historical cohort study based on exposure data (transfer day (blastocyst developmental stage reached by Day 5 or Day 6)) blastocyst developmental stage (1-6) and morphology (TE and inner cell mass (ICM): A, B, C)) and outcome data (preterm birth, birthweight, length at birth, and sex of the child) from women undergoing single blastocyst transfer resulting in a singleton pregnancy and live birth.Participants/materials, Setting, Methods: Data from 16 private and university-based facilities for clinical services and research were used. A total of 7246 women, who in 2014-2018 underwent fresh-embryo transfer with a single blastocyst or frozen-thawed embryo transfer (FET) with a single blastocyst resulting in a singleton pregnancy were identified. Linking to the Danish Medical Birth Registry resulted in a total of 4842 women with a live birth being included. Cycles with pre-implantation genetic testing and donated gametes were excluded. The analyses were adjusted for female age (n = 4842), female BMI (n = 4302), female smoking (n = 4290), parity (n = 4365), infertility diagnosis (n = 4765), type of treatment (n = 4842) and center (n = 4842); some analyses additionally included gestational age (n = 4368) and sex of the child (n = 4833).Main Results and the Role Of Chance: No statistically significant associations between blastocyst assessment scores (transfer day, developmental stage, TE, ICM) and preterm birth (8.3%) or birthweight (mean 3461.7 g) were found. The adjusted association between blastocysts with a TE score of C and a TE score of A and length at birth (mean 51.6 cm) were statistically significant (adjusted mean difference 0.4 cm (95% CI: 0.02; 0.77)). Blastocysts transferred with developmental stage score 5 compared to blastocysts transferred with score 3 had a 34% increased probability of being a boy (odds ratio (OR) 1.34 (95% CI: 1.09; 1.64). Further, TE score B blastocysts compared to TE score A blastocysts had a 31% reduced probability of being a boy (OR 0.69 (95% CI: 0.60; 0.80)).Limitations, Reasons For Caution: It is possible that some residual confounding remains.Wider Implications Of the Findings: Blastocyst selection during ART does not appear to introduce any negative effects on obstetric outcome. Therefore, clinicians and patients can be reassured that the assessment scores of the selected blastocyst will not in themselves pose a risk of preterm birth or affect birthweight and the length at birth.Study Funding/competing Interest(s): Unrestricted grant from Gedeon Richter Nordics AB, Sweden. None of the authors have any competing interest to declare.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

Study Question: Are obstetric and perinatal outcomes in pregnancies after fresh blastocyst transfer (BT) comparable with those born after fresh cleavage stage transfer (CT) and spontaneous conception (SC)?Summary Answer: Fresh BT is associated with a higher risk of placental and perinatal complications.What Is Known Already: BT optimizes the selection of top-quality embryos and increases pregnancy and live birth rates per transfer compared to CT. However, concerns have been raised as extended culture duration may increase obstetric complications and impair perinatal outcomes. Previous studies have shown a higher risk of preterm birth (PTB) among infants born after BT compared with CT. Pregnancies after BT are also prone to a higher risk of same-sex twins after single embryo transfer (SET).Study Design, Size, Duration: A retrospective register-based cohort study used data from Denmark, Norway and Sweden including three cohorts: 56 557 singletons and 16 315 twins born after fresh IVF/ICSI cycles and 2 808 323 SC singletons in Denmark (birth years 1997-2014), Norway (2010-2015) and Sweden (2002-2015). Of the fresh IVF/ICSI singletons, 4601 were born after BT and 51 956 after CT. The twin cohort consisted of 884 fresh IVF/ICSI children born after BT and 15 431 fresh IVF/ICSI children born after CT.Participants/materials, Setting, Methods: Data were obtained from a large Nordic cohort of children born after ART and SC initiated by the Committee of Nordic ART and Safety (CoNARTaS). The CoNARTaS cohort was established by cross-linking National ART-, Medical Birth-, and National Patients Registers using the unique personal identification number, allocated to every citizen in the Nordic countries. Obstetric and perinatal outcomes after BT, CT and SC were compared using logistic regression analysis. For perinatal outcomes, we calculated gestational age based on the date of oocyte pick-up (OPU) and in sensitivity analyses on data from Denmark and Norway, we also calculated gestational age based on the second-trimester ultrasonography (US) scan. Risk of pregnancies with same-sex twins after SET was used as a proxy for risk of monozygotic twins. Adjustments were made for child's sex, birth year, parity (0 or >1), maternal age, body mass index, smoking, educational level, fertilization method (IVF/ICSI), the number of aspirated oocytes, SET and country. Information on educational level and the number of aspirated oocytes was not available for Norway. Children born after frozen embryo transfer were not included. The birth cohorts were restricted according to the year in which BT was introduced in the different countries.Main Results and the Role Of Chance: A higher risk of placenta previa was found in singleton pregnancies after BT compared with CT (adjusted odds ratio [aOR] 2.11 [95% CI 1.76; 2.52]). Singletons born after BT had a higher risk of PTB (aOR 1.14 [95% CI 1.01; 1.29]) compared with CT singletons, when estimated based on OPU. Furthermore, an altered male/female ratio (aOR 1.13 [95% CI 1.06; 1.21]) with more males following BT compared with CT was seen. Risk of same-sex twins after SET was higher after single BT compared with single CT (aOR 1.94 [95% CI 1.42; 2.60]).Limitations, Reasons For Caution: Residual confounding cannot be excluded, in particular related to duration and cause of infertility that we could not adjust for due to lack of reliable data.Wider Implications Of the Findings: Extended embryo culture to the blastocyst stage has the potential to compromise obstetric and perinatal outcomes in fresh cycles. These results are important since an increasing number of IVF/ICSI treatments are performed as BT.Study Funding/competing Interest(s): NORDFORSK (project no: 71450). The Research Fund of Rigshospitalet, Copenhagen University Hospital. ReproUnion Collaborative study, co-financed by the European Union, Interreg V ÖKS. Grants from Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement (LUA/ALF 70940), Hjalmar Svensson Research Foundation. The Research Council of Norway through its Centres of Excellence funding scheme, project number 262700. None of the authors has any conflicts of interests to declare regarding this study.Trial Registration Number: ISRCTN11780826. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Does vitrification and warming of Day 3 embryos have an impact on neonatal outcome when compared with Day 3 embryos that are slow cooled and thawed, or with embryos from a fresh cycle? SUMMARY ANSWER The median birthweight was higher in the vitrified group versus the slow cooled or fresh embryo transfer, and the rate of low birthweight in twin babies was lower in the vitrified group. WHAT IS KNOWN ALREADY Vitrification has been successfully used for cryopreserving human oocytes and blastocyst-stage embryos. Most published studies looking at the neonatal outcomes after transfer of vitrified embryos refer to blastocyst-stage embryos. Information on children born after transfer of Day 3 vitrified embryos is relatively rare. STUDY DESIGN, SIZE, DURATION A retrospective, single-centre study of children born after Day 3 embryo transfer from fresh, slow frozen or vitrified embryos during the period January 2006 to May 2011 was conducted. Each patient contributed only one cycle per group. Children born were followed-up at 7–30 days after delivery. Outcome measures include obstetric and neonatal outcomes, which were evaluated by medical records and questionnaires sent to parents. PARTICIPANTS/MATERIALS, SETTING, METHODS Patients underwent transfer of vitrified Day 3 embryos (n = 2617 transfers, Cryotop method), slow frozen Day 3 embryos (n = 4681) and fresh Day 3 embryos (n = 9194). All cycles were performed at the Shanghai Ji Ai Genetics & IVF Institute. MAIN RESULTS AND THE ROLE OF CHANCE Frequencies of hypertensive disorder, gestational diabetes, placenta previa and abruptio placenta were similar in all groups. Five hundred and forty five, 986 and 1914 singleton babies were born from vitrified, slow freezing and fresh transfers, and the median gestational ages were 38.7, 38.7 and 38.7 weeks, respectively. Preterm birth (32–37 weeks) occurred in 7.5, 9.2 and 7.8% of the vitrified, slow freeze and fresh groups, respectively. The median birthweight from vitrified embryos (3455.3 g) was higher than that from slow freezing (3352.3 g) and fresh (3355.8 g) transfers (P < 0.0001 for both). The rate of perinatal mortality was 0.4% for all transfer groups. Three hundred and eighty two, 734 and 1322 twin babies were born from vitrified, slow freezing and fresh transfers, respectively. There were no differences among groups in mean gestational age and in the rate of preterm birth. The median birthweight for babies born from vitrified embryos (2587.4 g) was higher than that from the slow freezing (2538.8 g) or fresh (2494.4 g) transfer groups (vitrified versus fresh: P = 0.0015; vitrified versus slow freeze: P = 0.049). The rate of low birthweight (1500–2500 g) from vitrified (30.4%) was lower than that from fresh (36.2%) transfer (P = 0.034). LIMITATIONS, REASONS FOR CAUTION The main limitation of this study is that the obstetric and neonatal data were obtained by questionnaires sent to the parents without checking medical records. This is, especially, problematic for reporting on congenital malformations, so birth defects were excluded from the data. WIDER IMPLICATIONS OF THE FINDINGS Transfer of vitrified and warmed Day 3 embryos does not seem to have an adverse effect on neonatal outcome. Children born following the transfer of vitrified embryos seem to have a higher birthweight when compared with those of fresh or slow frozen embryos. STUDY FUNDING/COMPETING INTEREST(S) This study received no outside funding and none of the authors has any conflict of interest. [ABSTRACT FROM AUTHOR]

STUDY QUESTION What are the reproductive and obstetric outcomes in patients undergoing radical abdominal trachelectomy (RAT) for early-stage cervical cancer? SUMMARY ANSWER When RAT was performed before a pregnancy achieved with fertility treatments, pregnancy rate of 36.2% was obtained and 71.4% of these women gave birth at ≥32 weeks of gestation. WHAT IS KNOWN ALREADY Reproductive and obstetric outcomes after radical vaginal trachelectomy (RVT) are well documented; however, these outcomes after RAT have not been well studied. STUDY DESIGN, SIZE, DURATION This is a retrospective cohort study of patients at a single institution who underwent RAT and became pregnant. Reproductive and obstetric outcomes of 114 patients who had undergone RAT from September 2002 to December 2010 were investigated. PARTICIPANTS/MATERIAL, SETTING, METHODS Women of reproductive age with early-stage cervical cancer who wished to preserve their fertility were documented. MAIN RESULTS AND THE ROLE OF CHANCE Patients' median age was 33 years (25–40 years). A total of 31 pregnancies were achieved in 25 patients and 6 patients had 2 pregnancies. Eighteen of 25 patients (72.0%) had infertility problems; 17 patients conceived with IVF-embryo transfer and 1 patient with intrauterine insemination. The pregnancy rate among patients who wished to conceive was 36.2% (25/69). Among 31 pregnancies in 25 patients, 4 patients had first trimester miscarriage and 1 patient had second trimester miscarriage. Excluding the five patients who miscarried and the five ongoing pregnancies, all the 21 patients had deliveries by Cesarean section. Four patients had a preterm birth in the second trimester and 17 patients delivered in the third trimester. Of the 17 pregnancies that reached the third trimester, 2 (11.8%) were preterm births between 29 and 32 weeks, 11 (64.7%) were delivered between 32 and 37 weeks and 4 (23.5%) at ≥37 weeks of gestation. LIMITATIONS, REASONS FOR CAUTION Because of the retrospective data collection, not all pregnancies may have been recorded. WIDER IMPLICATIONS OF THE FINDINGS Prospective multicenter studies are needed to determine if the results shown in this retrospective cohort can be generalized to all patients with early-stage cervical cancer who wish to undergo the fertility-sparing RAT procedure. STUDY FUNDING/COMPETING INTEREST(S) There was no funding for this study. No conflicts of interest. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Do births following single embryo transfers (SET) have a reduced risk of perinatal mortality compared with those following double embryo transfers (DET)? SUMMARY ANSWER SET is associated with reduced risk of perinatal mortality compared with DET. WHAT IS KNOWN ALREADY Fetal, neonatal and perinatal mortality are important indicators for monitoring pregnancy and childbirth, particularly for births following assisted reproductive technology (ART) treatments. Following the introduction of SET, there has been a decline in the perinatal mortality rate (PMR) among babies born after ART in Australia and New Zealand. STUDY DESIGN, SIZE, DURATION This population study (census) included 50 258 births of ≥20 weeks gestation and/or ≥400 g of birthweight following embryos transfer cycles in Australia and New Zealand during the period 2004–2008. PARTICIPANTS/MATERIALS, SETTING, METHODS The PMR was calculated according to the number of embryos transferred and other demographic and treatment-related factors. Perinatal deaths were defined as the number of fetal deaths (stillbirths) plus the number of neonatal deaths (deaths that occur before 28 days after birth). MAIN RESULTS AND THE ROLE OF CHANCE The PMR was 16.2 per 1000 births (n= 813). Of the 813 perinatal deaths, 630 were fetal deaths and 183 neonatal deaths. Twins had a significantly higher PMR (27.8 per 1000 births) than singletons (12.4 per 1000 births). The risk of perinatal mortality for all births following DET was 53% higher than for all births following SET (adjusted risk ratio 1.53, 95% confidence interval (95% CI): 1.29–1.80). Births following fresh DET had a 58% increased risk of perinatal mortality compared with births following fresh SET (risk ratio 1.58, 95% CI: 1.32–1.90). LIMITATIONS, REASONS FOR CAUTION Information on outcomes was missing from <1% of clinical pregnancies recorded in Australian and New Zealand Assisted Reproduction Database for the study period. There are no data on the timing of fetal death, the cause of perinatal death or on late termination of pregnancy at ≥20 weeks' gestation. WIDER IMPLICATIONS OF THE FINDINGS Double and higher order embryo transfer is associated with a higher risk of perinatal mortality when compared with SET. The number of embryos transferred is determined by the clinician with consent of the patient and is a modifiable treatment factor. SET should be advocated as the first-line management in ART as it is the single most effective public health intervention for preventing excess perinatal mortality among ART pregnancies. STUDY FUNDING/COMPETING INTEREST(S) Nil. [ABSTRACT FROM AUTHOR]

BACKGROUND There is increasing use of cryopreservation in IVF. This study compared singletons born after cryopreservation with singletons born after fresh IVF cycles and singletons born to women in the general population. METHODS Data were collected for Swedish IVF treatments during the years 2002–2006. All singletons from single embryo transfer (SET) and double embryo transfer (DET) after cryopreserved (n = 2348) and fresh cycles (n = 8944) were included and cross-linked with the Swedish Medical Birth Registry and compared with all singletons born after spontaneous conception (n = 571 914). Main outcomes were preterm and very preterm birth and low and very low birthweight (VLBW). Other outcomes were small for gestational age, large for gestational age (LGA), perinatal mortality and maternal outcomes. RESULTS Singletons from cryopreserved SET/DET or cryopreserved SET had increased rates of extreme preterm birth compared with singletons from the general population. A lower rate of LBW was found for cryopreserved SET/DET singletons compared with singletons from fresh cycles; however, a higher rate of perinatal mortality was detected. The rates of LGA and macrosomia were increased for cryopreserved SET/DET singletons when compared with those from fresh cycles and the general population. For maternal outcomes, a higher rate of pre-eclampsia was noted for pregnancies from cryopreserved cycles compared with those from fresh cycles or the general population, but the rate of placenta praevia was lower in pregnancies from cryopreserved cycles compared with those from fresh cycles. CONCLUSIONS The obstetric outcome of singletons after cryopreservation was slightly poorer when compared with the general population. In comparison with fresh cycles, the outcome varied. The finding of an increased rate of LGA after cryopreservation requires further study. [ABSTRACT FROM PUBLISHER]

BACKGROUND Singletons born after IVF have an adverse perinatal outcome when compared with singletons in the general population. This study investigates maternal characteristics and IVF- treatment-related variables, for a possible influence on obstetric outcomes. METHODS Data from all IVF clinics in Sweden, including all IVF singletons born after fresh treatment cycles and own oocytes during 2002–2006, were included (n= 8941) and cross-linked with the Swedish Medical Birth Registry. Four major outcomes were investigated: very preterm birth (<32 weeks), small for gestational age (SGA), placenta previa and placental abruption. Maternal characteristics (age, parity, BMI, smoking and years of infertility) and treatment-related variables (number of oocytes retrieved, number of embryo culture days, number of transferred and cryopreserved embryos, ‘vanishing twin’) were investigated for independent association with the four selected outcomes. Adjusted odds ratios (AORs) were calculated by logistic regression. RESULTS Primiparity, smoking, BMI and ‘vanishing twin’ were associated with an increased risk of very preterm birth. Maternal age, primiparity, smoking, BMI and years of infertility were associated with an increased risk of SGA. Maternal age and blastocyst transfer were associated with an increased risk, and primiparity with a decreased risk, of placenta previa. Smoking was significantly associated with placental abruption. CONCLUSIONS In singletons born after fresh IVF, certain maternal characteristics and the number of embryos transferred, when there was a ‘vanishing twin’ affected the obstetric outcome negatively. An increased rate of placenta previa was observed after blastocyst transfer. The results support the use of single embryo transfer and indicate that lifestyle factors are important for obstetric outcome. [ABSTRACT FROM PUBLISHER]

BACKGROUND IVF children, including singletons, are known to have a poorer obstetric outcome than children born after spontaneous conception. With a broad introduction of single embryo transfer (SET), this scenario might change. This study compares the obstetric outcome after IVF with SET, elective SET (eSET), non elective SET (non-eSET) and double embryo transfer (DET) with outcomes in the general population. METHODS All IVF children born in Sweden after IVF treatment during the years 2002–2006 (n= 13 544 children) were included and compared with all non-IVF children born during the same time period (n= 587 009 children). Data were collected from all 16 Swedish IVF clinics and cross-linked with the Swedish Medical Birth Registry. Main outcomes were preterm birth (<28, <32 and <37 w), very-low-birthweight (VLBW) and low-birthweight (LBW). Adjusted odds ratios were calculated. RESULTS In total, 7763 children were born after SET and 5724 children after DET. Comparing all SET children, irrespective of multiplicity, with all children in the general population, significantly higher rates of <28 w was found for the IVF children. Comparing IVF singletons, irrespective of SET and DET with non-IVF singletons from the general population, significantly higher rates of <28 w, <37 w, LBW and VLBW were found. eSET singletons, compared with singletons in the general population, had a significantly higher rate of <37 w and non-eSET singletons had significantly higher rates of <28 w and <2500 g births. CONCLUSIONS Children born after IVF had a poorer obstetric outcome compared with children from the general population. Singletons, when analysed as one group, irrespective of whether the children were born after eSET, non-eSET or DET, also had a poorer obstetric outcome with higher rates of preterm and LBW compared with singletons in the general population. [ABSTRACT FROM AUTHOR]

BACKGROUND: It has been claimed that the risks to the child resulting from vitrification as compared with the slow-freezing technique, may be higher owing to the high concentrations of potentially toxic cryoprotectants. We therefore retrospectively compared the obstetric and neonatal outcomes in a cohort of children born after transfer of vitrified blastocysts, fresh blastocysts and slow-frozen early cleavage stage embryos. METHODS: All children born after transfer of vitrified blastocysts (n = 106), fresh blastocysts (n = 207) and slow frozen early cleavage stage embryos (n = 206) during the period January 2006 to May 2008 at Fertility Center Scandinavia were included. Data on obstetric and neonatal outcomes were obtained from medical records from the antenatal and delivery clinics. RESULTS: For singletons, there were no significant differences between the groups in gestational age, mortality or birth defects. After adjustment for parity and BMI, birthweight was significantly higher in singletons born after transfer of vitrified blastocysts as compared with after transfer of fresh blastocysts (median 3560 versus 3510 g, P = 0.0311). More singletons born after transfer of fresh blastocysts were small for gestational age compared with singletons born after transfer of vitrified blastocysts (12.1 versus 3.0%, P = 0.0085). A higher rate of major post-partum haemorrhage was observed in the vitrified blastocyst group as compared with the other two groups (25.0 versus 6.0 and 7.5%). CONCLUSIONS: No adverse neonatal outcomes were observed in children born after transfer of vitrified, as compared with fresh blastocysts or after transfer of slow-frozen early cleavage stage embryos. [ABSTRACT FROM AUTHOR]

BACKGROUND: The number of children born after frozen embryo transfer (FET) is steadily rising. However, studies on obstetric and perinatal outcomes are limited. Our primary aim was to compare the perinatal health of children born after FET and fresh embryo transfer, and to use data from children born after spontaneous conception as a reference. [ABSTRACT FROM PUBLISHER]

Background: Infertility itself and also assisted reproductive treatment increase the incidence of some obstetric complications. Women with unexplained infertility are reported to be at an increased risk of intrauterine growth restriction during pregnancy, but not for other perinatal complications.Methods: A matched case-control study was performed on care during pregnancy and delivery, obstetric complications and infant perinatal outcomes of 107 women with unexplained infertility, with 118 clinical pregnancies after IVF or ICSI treatment. These resulted in 90 deliveries; of these, 69 were singleton, 20 twin and one triplet. Two control groups were chosen from the Finnish Medical Birth Register, one group for spontaneous pregnancies (including 445 women and 545 children), matched according to maternal age, parity, year of birth, mother's residence and number of children at birth, and the other group for all pregnancies after IVF, ICSI or frozen embryo transfer treatment (FET) during the study period (including 2377 women and 2853 children).Results: Among singletons, no difference was found in the mean birthweight, and the incidence of low birthweight (<2500 g) was comparable with that of the control groups. No differences were found in gestational duration, major congenital malformations or perinatal mortality among the groups studied. Among singletons in the study group, there were more term breech presentations (10.1%) compared with both spontaneously conceiving women and all IVF women (P < 0.01). The rate of pregnancy-induced hypertension was significantly lower among singletons in the study group (P < 0.05) compared with other IVF singletons. The multiple pregnancy rate was 23.3% in the study group. The obstetric outcome of the IVF twins was similar to both control groups.Conclusions: The overall obstetric outcome among couples with unexplained infertility treated with IVF was good, with similar outcome compared with spontaneous pregnancies and IVF pregnancies generally. [ABSTRACT FROM AUTHOR]

This paper provides an overview of the effects of cryopreservation on obstetric outcome and child development. Cryopreservation of embryos has no apparent negative impact on perinatal outcome and early infant development. The available data do not indicate an elevated congenital malformation rate. Intracytoplasmic sperm injection and cryopreservation is comparable with conventional in-vitro fertilization and cryopreservation. It remains unclear if embryo freezing poses long-term risks to children so conceived. There are several potential advantages of oocyte freezing which, however, is still a research procedure. [ABSTRACT FROM PUBLISHER]

The aim of this study was to describe the obstetric and perinatal outcome for births following intracytoplasmic sperm injection (ICSI). Of 210 infants born, 140 were singletons and 70 were twins. There were no triplets or higher births. The multiple birth frequency was 20%. Overall, 17% of deliveries were preterm, although for singleton pregnancies the incidence was reduced to 9%. The median birth weight of all live born infants was 3168 g and of singletons 3470 g. Of all infants, 17% had a low birth weight (<2500 g) and 2% had a very low birth weight (<1500 g). Two major malformations occurred in two singleton children and four minor malformations occurred in four children. This was within the range of expected values in Sweden. Karyotyping was performed in 58 pregnancies. All of them were normal. The perinatal mortality was 0.5%. In conclusion, in this observational study from Sweden of the first infants born after ICSI in our programme, the incidence of multiple births, preterm births, low birth weight babies and congenital malformations was low compared with other series of in-vitro fertilization pregnancies not associated with ICSI. [ABSTRACT FROM PUBLISHER]

The present study compares 465 singleton live deliveries from in-vitro fertilization/gamete intra-Fallopian transfer (IVF/GIFT) pregnancies with a large control population to evaluate the incidence of pre-term delivery and small for gestational age (SGA) or very small for gestation age (VSGA) babies resulting from IVF/GIFT pregnancies. Overall the incidence of SGA or VSGA from an IVF/GIFT pregnancy is higher than from the normal obstetric population (SGA odds ratio 1.76, 95% confidence interval (CI): 1.38–2.25 and VSGA odds ratio 1.61, 95% CI: 1.05–2.46) particularly among primiparous women (SGA odds ratio 1.99, 95% CI: 1.25–3.16 and VSGA odds ratio 1.97, 95% CI: 1.49–2.62). After stratifying by the cause of infertility, only women with unexplained infertility had a significantly higher proportion of SGA/VSGA babies. There was a significantly higher incidence of pre-term deliveries among the young primiparae (odds ratio 5.02, 95% CI: 3.09–8.13). Thus the excess risk of delivering a SGA/VSGA baby and pre-term delivery from an IVF/GIFT pregnancy seems to be largely confined to women with unexplained infertility and young primiparae. [ABSTRACT FROM PUBLISHER]

In a patient with primary infertility, ovulation was induced by monitored stimulation with human menopausal gonadotrophins (HMG) because of polycystic ovarian disease. Infertility work-up had shown a unicornuate uterus with a cavitary communicating rudimentary horn. The husband showed a varicocele-related moderate oligo-asthenoteratozoospermia. A triplet pregnancy occurred in a third HMG ovulation induction cycle combined with intra-uterine insemination of the husband's washed semen. The pregnancy was carefully monitored, and measures to prevent premature delivery were taken. Because of the patient's obvious discomfort in the presence of premature labour, Caesarean section was performed at 33 weeks gestation and three healthy infants were delivered. This is the first report of a successful triplet pregnancy in a women with a unicornuate uterus. The reproductive and obstetric outcome of this condition in general, and in the case of multiple pregnancy, is discussed. [ABSTRACT FROM AUTHOR]

Selective reduction in cases of multiple fetuses is used more often nowadays due to the increased number of multiple pregnancies resulting from assisted reproduction. In this retrospective study, we investigated whether twin pregnancies derived from fetal reduction carry a higher obstetric and perinatal risk compared to standard twin pregnancies. We found that the rate of miscarriage was 10.6% in the reduction group (n = 158) compared to 9.5% in the controls (n = 135). Mean gestational age at delivery was 35.7 weeks in the reduction group versus 35.1 weeks in the control group. Mean neonatal weight at birth was 2.260 g (800–3.750 g) in the reduction group compared to 2.240 g (540–3.360 g) in controls. Perinatal mortality rate was 49.3‰ after reduction and 42.0‰ in the control group. There was no statistically significant difference in any of the above parameters. Therefore, multifetal pregnancy reduction to twins does not appear to increase obstetric or perinatal risks. [ABSTRACT FROM PUBLISHER]