Association between in vitro fertilisation embryo transfer and placental pathology in women with preterm birth: a retrospective cohort study
Kyong-No Lee A # , Eunjin Song A # , Sukjeong Lee A , Iseop Cho A , Hyeon Ji Kim
A * , Jee Yoon Park A and Kyung Joon Oh A
+ Author Affiliations
- Author Affiliations
A Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
* Correspondence to: kkmk96@naver.com
# These authors contributed equally to this paper
Handling Editor: Alison Care
Reproduction, Fertility and Development 34(18) 1107-1114 https://doi.org/10.1071/RD22184
Published online: 18 October 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing
Abstract
Context: The number of women who achieve pregnancy through assisted reproductive technology (ART), including in vitro fertilisation and embryo transfer (IVF-ET), is increasing worldwide. Placenta-mediated diseases associated with ART, such as gestational hypertension, preeclampsia, disorders of placental implantation, and placental abruption, are also increasing.
Aims: To determine the association between placental pathologies and IVF-ET in women with preterm births.
Methods: This retrospective cohort study examined archived placenta specimens of women who achieved pregnancy through either spontaneous conception or IVF-ET. In total, 1677 women with singleton pregnancies who gave birth consecutively between 20 and 37 weeks of gestation at Seoul National University Bundang Hospital and underwent placental pathologic evaluation between April 2013 and October 2018 were included. Data from all pathologic reports were reviewed.
Key results: The IVF-ET group had a higher median maternal age and rate of nulliparity than the natural conception group. The incidence rate of obstetric complications, except preterm premature rupture of membranes and placenta previa, was similar in both groups. The IVF-ET group had a higher incidence rate of placental infarction than the natural conception group (26.4% vs 16.4%, P = 0.012). Multivariate logistic regression analysis indicated that IVF, hypertensive disorders, and fetal growth restriction were significantly associated with placental infarction.
Conclusions: IVF-ET was independently associated with the risk of placental infarction in women with preterm births.
Implications: The use of IVF-ET may cause abnormal placental formation with an increased risk of anatomical and vascular pathology, which are observed in preterm deliveries and may contribute to pregnancy complications.
Keywords: assisted reproductive technology, caesarean section, fetal growth restriction, hypertension in pregnancy, in vitro fertilisation, placenta biopsy, placental infarction, preterm birth.
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