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Risk of Stillbirth Four Times Higher After IVF/ICSI Compared to Spontaneous Pregnancies
Women who become pregnant with a single fetus after in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) have an increased risk of a stillbirth, according to new research.
The study of over 20,000 singleton pregnancies, published in Europe's leading reproductive medicine journal Human Reproduction, found a four-fold increased risk of stillbirths for women who had IVF/ICSI compared with women who conceived spontaneously or after fertility treatment that did not involve IVF or ICSI.
However, the authors of the Danish study say that these results should be interpreted carefully. Dr Kirsten Wisborg, who led the study, said: "It is important to remember that the risk of stillbirth is still very low among women pregnant after IVF/ICSI. At this stage we do not know whether the increased risk in women pregnant after IVF/ICSI is due to the fertility treatment or to unknown factors pertaining to couples who undergo IVF/ICSI. This needs further investigation."
Dr Wisborg, who is a consultant in the neonatal and intensive care unit at Aarhus University Hospital (Aarhus, Denmark), and colleagues analysed data that had been collected prospectively from unselected, pregnant women taking part in the Aarhus Birth Cohort. The study included information on women booked for delivery between August 1989 and October 2006. Information on obstetric history, including waiting times to pregnancy and fertility treatments, age, smoking habits during pregnancy, alcohol and coffee intake during pregnancy, marital status, education and any psychological problems was collected in two questionnaires completed before the first routine antenatal visit at 16 weeks gestation.
Out of a total of 20,166 singleton, first-time pregnancies, 16,525 (82%) were conceived spontaneously after less than 12 months, 2,020 (10%) after more than a year of trying (classified as sub-fertile), 879 (4%) conceived after non-IVF fertility treatment and 742 (4%) conceived after IVF/ICSI. There was a total of 86 stillbirths, giving an overall risk of stillbirth of 4.3 per thousand pregnancies.
The risk of stillbirth in women who conceived after IVF/ICSI was 16.2 per thousand; in women who conceived after non-IVF fertility treatment it was 2.3 per thousand; in fertile and sub-fertile women, the risk was 3.7 per thousand and 5.4 per thousand respectively. Read more.