Julia F Litzky1, Sheree L Boulet2, Navid Esfandiari3,4, Yujia Zhang2, Dmitry M Kissin2, Regan N Theiler5, Carmen J Marsit6. 1. Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, 03755, USA. 2. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, 30341, USA. 3. Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth College, Hanover, NH, 03755, USA. 4. Department of Pathology and Laboratory Medicine, Geisel School of Medicine at Dartmouth College, Hanover, NH, 03755, USA. 5. Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, 55905, USA. 6. Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA. carmen.j.marsit@emory.edu.
Abstract
PURPOSE: In vitro fertilization (IVF) infants have lower birthweights than their peers, predisposing them to long-term health consequences. Blastocyst transfer (BT), at day 5-6 post-fertilization, is increasing in usage, partially due to improved pregnancy outcomes over cleavage-stage transfer (CT, day 2-3). Data to date, however, have been inconclusive regarding BT's effects on birthweight. METHODS: Participants included all US autologous, single-gestation, fresh embryo transfer cycles initiated from 2007 to 2014 that resulted in a term infant (N = 124,154) from the National Assisted Reproductive Technology Surveillance System. Generalized linear models including obstetric history, maternal demographics, and infant sex and gestational age were used to compare birthweight outcomes for infants born following BT (N = 67,169) with infants born following CT (N = 56,985) and to test for an interaction between transfer stage and single embryo transfer (SET). RESULTS: Infants born following BT were 6 g larger than those born following CT (p = 0.04), but rates of macrosomia (RR 1.00, 95% CI 0.96-1.04) and low birthweight (LBW, RR 1.00, 95% CI 0.93-1.06) were not different between the groups. The interaction between SET and transfer stage was significant (p = 0.02). Among SET infants, BT was associated with 19.26 g increased birthweight compared to CT (p = 0.008). CONCLUSIONS: The increase in birthweights identified following BT is unlikely to be clinically relevant, as there were no differences in rates of macrosomia or LBW. These findings are clinically reassuring and indicate that the increasing use of BT is unlikely to further decrease the on average lower birthweights seen in IVF infants compared to their naturally conceived peers.
PURPOSE: In vitro fertilization (IVF) infants have lower birthweights than their peers, predisposing them to long-term health consequences. Blastocyst transfer (BT), at day 5-6 post-fertilization, is increasing in usage, partially due to improved pregnancy outcomes over cleavage-stage transfer (CT, day 2-3). Data to date, however, have been inconclusive regarding BT's effects on birthweight. METHODS:Participants included all US autologous, single-gestation, fresh embryo transfer cycles initiated from 2007 to 2014 that resulted in a term infant (N = 124,154) from the National Assisted Reproductive Technology Surveillance System. Generalized linear models including obstetric history, maternal demographics, and infant sex and gestational age were used to compare birthweight outcomes for infants born following BT (N = 67,169) with infants born following CT (N = 56,985) and to test for an interaction between transfer stage and single embryo transfer (SET). RESULTS:Infants born following BT were 6 g larger than those born following CT (p = 0.04), but rates of macrosomia (RR 1.00, 95% CI 0.96-1.04) and low birthweight (LBW, RR 1.00, 95% CI 0.93-1.06) were not different between the groups. The interaction between SET and transfer stage was significant (p = 0.02). Among SET infants, BT was associated with 19.26 g increased birthweight compared to CT (p = 0.008). CONCLUSIONS: The increase in birthweights identified following BT is unlikely to be clinically relevant, as there were no differences in rates of macrosomia or LBW. These findings are clinically reassuring and indicate that the increasing use of BT is unlikely to further decrease the on average lower birthweights seen in IVFinfants compared to their naturally conceived peers.
Entities:
Keywords:
Birthweight; Blastocyst; Cleavage-stage embryo; Embryo transfer; In vitro fertilization
Authors: Amin A Milki; Sunny H Jun; Mary D Hinckley; Lynn W Westphal; Linda C Giudice; Barry Behr Journal: J Assist Reprod Genet Date: 2003-08 Impact factor: 3.412
Authors: Saswati Sunderam; Dmitry M Kissin; Sara B Crawford; Suzanne G Folger; Denise J Jamieson; Lee Warner; Wanda D Barfield Journal: MMWR Surveill Summ Date: 2015-12-04