Maternofetal morbidity in pregnancies after in vitro fertilization.

Introduction/aim. The health of children born after assisted reproduction is of major interest, since already up to 6% of children born in European countries are the result of assisted reproductive techniques (ARTs). Frozen embryo transfers (FETs) are on a steep rise and comprise 32.6% of all ART treatment cycles in Europe. Although most in vitro fertilization (IVF) pregnancies are uncomplicated, there is an association with increased risks of maternal, fetal and perinatal outcomes. Methodology. The retrospective, descriptive study included 300 cases of in vitro fertilization pregnancies hospitalized in our department between 2016 and 2022. We recommend genetic counseling to all patients who have undergone IVF with or without intracytoplasmic sperm injection (ICSI). Results and discussion. The accuracy of firsttrimester genetic screening tests for aneuploidies may be affected by IVF, with a potential increased risk of false positive results for aneuploidies in patients who undergo first-trimester combined screening. We did not find associations between IVF (with and without ICSI) and congenital malformations. Several placental implantation disorders are more common with IVF (higher risk for abnormal placental structure: bilobed placenta, accessory placental lobes, placenta praevia, vasa praevia). We found a higher risk for preterm birth, low birth weight, very low birth weight and preeclampsia. Risks are more than doubled in IVF twin gestations. The assessment of fetal growth should be performed in the third trimester, with weekly antenatal fetal surveillance beginning by 36 weeks. Conclusions. IVF is associated with an increased risk of adverse maternal and perinatal outcomes. However, evidence is limited regarding whether specific screening, diagnostic or preventative interventions during pregnancy obviate or reduce such risks. Specific technical characteristics of IVF and the presence of underlying infertility affect the risks of adverse clinical outcomes. Therefore, individualization of care may be ideal for optimizing outcomes. [ABSTRACT FROM AUTHOR]