Barbara Luke1, Judy E Stern2, Milton Kotelchuck3, Eugene R Declercq4, Mark D Hornstein5, Daksha Gopal4, Lan Hoang4, Hafsatou Diop6. 1. Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, East Lansing, Michigan. Electronic address: lukeb@msu.edu. 2. Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. 3. MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts. 4. Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts. 5. Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. 6. Massachusetts Department of Public Health, Boston, Massachusetts.
Abstract
OBJECTIVE: To evaluate risks for adverse pregnancy outcomes by number of embryos transferred (ET) and fetal heartbeats (FHB) in assisted reproductive technology-conceived singleton live births. DESIGN: Longitudinal cohort using cycles reported to the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System between 2004 and 2008 among women who were treated and gave birth in Massachusetts. SETTING: Not applicable. PATIENT(S): Assisted reproductive technology data on 6,073 births between 2004 and 2008 were linked to vital records and hospital data. Likelihood of ET ≥3 vs. 1-2, FHB >1 vs. 1, and risks of preterm birth (PTB, <37 weeks' gestation), low birth weight (LBW, <2,500 g), and small-for-gestational-age birth weight (SGA, <10th percentile) with FHB >1 were modeled with binary logistic regression using a backward-stepping algorithm, and presented as adjusted odds ratios (95% confidence intervals). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): ET ≥3, FHB >1, PTB, LBW, and SGA. RESULT(S): Higher ET was significantly more likely with older maternal age, intracytoplasmic sperm injection, assisted hatching, cleavage-stage embryos, and thawed embryos. The likelihood of FHB >1 with ≥3 ET vs. 1-2 ET was 2.04 (1.68-2.48). Risks of PTB and LBW with FHB >1 were 1.63 (1.27-2.09) and 1.81 (1.36-2.39), respectively; the risk of SGA was not significant. Nulliparity was associated with higher risks of PTB (1.34 [1.12-1.59]), LBW (1.48 [1.20-1.83]), and SGA (2.17 [1.69-2.78]). CONCLUSION(S): Number of embryos transferred was strongly associated with FHBs, with twice the risk of FHB >1 with ≥3 ET vs. 1-2 ET. Increasing FHBs were associated with significantly greater risks for PTB and LBW outcomes.
RCT Entities:
OBJECTIVE: To evaluate risks for adverse pregnancy outcomes by number of embryos transferred (ET) and fetal heartbeats (FHB) in assisted reproductive technology-conceived singleton live births. DESIGN: Longitudinal cohort using cycles reported to the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System between 2004 and 2008 among women who were treated and gave birth in Massachusetts. SETTING: Not applicable. PATIENT(S): Assisted reproductive technology data on 6,073 births between 2004 and 2008 were linked to vital records and hospital data. Likelihood of ET ≥3 vs. 1-2, FHB >1 vs. 1, and risks of preterm birth (PTB, <37 weeks' gestation), low birth weight (LBW, <2,500 g), and small-for-gestational-age birth weight (SGA, <10th percentile) with FHB >1 were modeled with binary logistic regression using a backward-stepping algorithm, and presented as adjusted odds ratios (95% confidence intervals). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): ET ≥3, FHB >1, PTB, LBW, and SGA. RESULT(S): Higher ET was significantly more likely with older maternal age, intracytoplasmic sperm injection, assisted hatching, cleavage-stage embryos, and thawed embryos. The likelihood of FHB >1 with ≥3 ET vs. 1-2 ET was 2.04 (1.68-2.48). Risks of PTB and LBW with FHB >1 were 1.63 (1.27-2.09) and 1.81 (1.36-2.39), respectively; the risk of SGA was not significant. Nulliparity was associated with higher risks of PTB (1.34 [1.12-1.59]), LBW (1.48 [1.20-1.83]), and SGA (2.17 [1.69-2.78]). CONCLUSION(S): Number of embryos transferred was strongly associated with FHBs, with twice the risk of FHB >1 with ≥3 ET vs. 1-2 ET. Increasing FHBs were associated with significantly greater risks for PTB and LBW outcomes.
Authors: Barbara Luke; Morton B Brown; David A Grainger; Judy E Stern; Nancy Klein; Marcelle I Cedars Journal: Fertil Steril Date: 2008-09-18 Impact factor: 7.329
Authors: Barbara Luke; Morton B Brown; David A Grainger; Judy E Stern; Nancy Klein; Marcelle I Cedars Journal: Fertil Steril Date: 2008-06-18 Impact factor: 7.329
Authors: Caitlin R Sacha; Daksha Gopal; Chia-Ling Liu; Howard R Cabral; Judy E Stern; Daniela A Carusi; Catherine Racowsky; Charles L Bormann Journal: Fertil Steril Date: 2022-04-23 Impact factor: 7.490
Authors: Aaron K Styer; Barbara Luke; Wendy Vitek; Mindy S Christianson; Valerie L Baker; Alicia Y Christy; Alex J Polotsky Journal: Fertil Steril Date: 2016-03-18 Impact factor: 7.329
Authors: Barbara Luke; Judy E Stern; Mark D Hornstein; Milton Kotelchuck; Hafsatou Diop; Howard Cabral; Eugene R Declercq Journal: J Assist Reprod Genet Date: 2015-12-03 Impact factor: 3.412
Authors: Judy E Stern; Daksha Gopal; Hafsatou Diop; Stacey A Missmer; Charles C Coddington; Barbara Luke Journal: J Assist Reprod Genet Date: 2017-06-01 Impact factor: 3.412