Any Beltran Anzola1, Vanessa Pauly2, Olivier Riviere3, Roland Sambuc4, Pierre Boyer5, Françoise Vendittelli6, Marie-José Gervoise-Boyer7. 1. EA 3279, Centre d'Etudes et de Recherche sur les Services de Santé et la Qualité de Vie (CEReSS), Aix-Marseille Université, Faculté de Médecine, 27 Boulevard Jean Moulin, Marseille 13005, France; Centre Sainte Colette, Service de Médecine et Biologie de la Reproduction, Hôpital Saint Joseph, 26 Boulevard de Louvain, Marseille 13008, France. 2. Service d'Information Médicale, Hôpital de la Conception, Assistance Publique Hôpitaux de Marseille, 147 Boulevard Baille, Marseille 13005, France. 3. AUDIPOG (Association des Utilisateurs de Dossiers Informatisés en Pédiatrie, Obstétrique et Gynécologie), Université Claude Bernard Lyon 1, Laennec, 7 Rue Guillaume Paradin, Lyon Cedex 08 69372, France. 4. EA 3279, Centre d'Etudes et de Recherche sur les Services de Santé et la Qualité de Vie (CEReSS), Aix-Marseille Université, Faculté de Médecine, 27 Boulevard Jean Moulin, Marseille 13005, France; Service d'Information Médicale, Hôpital de la Conception, Assistance Publique Hôpitaux de Marseille, 147 Boulevard Baille, Marseille 13005, France. 5. Centre Sainte Colette, Service de Médecine et Biologie de la Reproduction, Hôpital Saint Joseph, 26 Boulevard de Louvain, Marseille 13008, France. Electronic address: pboyer@hopital-saint-joseph.fr. 6. AUDIPOG (Association des Utilisateurs de Dossiers Informatisés en Pédiatrie, Obstétrique et Gynécologie), Université Claude Bernard Lyon 1, Laennec, 7 Rue Guillaume Paradin, Lyon Cedex 08 69372, France; Service de Gynécologie-obstétrique, Université Clermont Auvergne, CNRS, Institut Pascal, CHU de Clermont-Ferrand, 1 Place Lucie-Aubrac, Clermont-Ferrand 63003, France. 7. Centre Sainte Colette, Service de Médecine et Biologie de la Reproduction, Hôpital Saint Joseph, 26 Boulevard de Louvain, Marseille 13008, France.
Abstract
RESEARCH QUESTION: Does fresh embryo transfer after IVF with or without intracytoplasmic sperm injection (ICSI) increase the small for gestational age (SGA) rate, and frozen embryo transfer (FET) after IVF with or without ICSI increase the large for gestational age (LGA) rate versus natural conception? DESIGN: Retrospective comparison of an exposed historical group/cohort involving singletons conceived after fresh embryo transfer and after FET with an unexposed group/cohort involving singletons conceived after a natural conception. RESULTS: A total of 1961 fresh embryo transfer babies and 366 FET babies were compared with 6981 natural conception babies. The SGA rate in fresh embryo transfer babies was not significantly different to natural conception babies (6.9% versus 6.8%, P = 0.856). This outcome was not influenced by the fresh embryo transfer (adjusted odds ratio [aOR] 1.0; 95% confidence interval [CI] 0.8-1.3), but rather by a low rate of multiparity (aOR 0.5; 95% CI 0.3-0.7), advanced maternal age (aOR 1.1; 95% CI 1.0-1.2), maternal underweight (aOR 1.5; 95% CI 1.1-2.1), maternal smoking or cessation during pregnancy (aOR 1.8; 95% CI 1.4-2.3), pre-existing hypertension (aOR 2.3; 95% CI 1.3-4.1) and pregnancy-induced hypertension (aOR 2.5; 95% CI 1.7-3.7). The LGA rate in FET babies was significantly different from natural conception babies (6.6% versus 3.2%, P = 0.012). This outcome was influenced by the transfer of frozen embryos (aOR 2.2; 95% CI 1.3-3.8) and by a high maternal weight (aOR 1.9; 95% CI 1.1-3.6). CONCLUSIONS: Maternal background and obstetric parameters are more likely to influence the SGA rate than fresh embryo transfer conception. FET conception could be associated with an increase in LGA rate.
RESEARCH QUESTION: Does fresh embryo transfer after IVF with or without intracytoplasmic sperm injection (ICSI) increase the small for gestational age (SGA) rate, and frozen embryo transfer (FET) after IVF with or without ICSI increase the large for gestational age (LGA) rate versus natural conception? DESIGN: Retrospective comparison of an exposed historical group/cohort involving singletons conceived after fresh embryo transfer and after FET with an unexposed group/cohort involving singletons conceived after a natural conception. RESULTS: A total of 1961 fresh embryo transfer babies and 366 FET babies were compared with 6981 natural conception babies. The SGA rate in fresh embryo transfer babies was not significantly different to natural conception babies (6.9% versus 6.8%, P = 0.856). This outcome was not influenced by the fresh embryo transfer (adjusted odds ratio [aOR] 1.0; 95% confidence interval [CI] 0.8-1.3), but rather by a low rate of multiparity (aOR 0.5; 95% CI 0.3-0.7), advanced maternal age (aOR 1.1; 95% CI 1.0-1.2), maternal underweight (aOR 1.5; 95% CI 1.1-2.1), maternal smoking or cessation during pregnancy (aOR 1.8; 95% CI 1.4-2.3), pre-existing hypertension (aOR 2.3; 95% CI 1.3-4.1) and pregnancy-induced hypertension (aOR 2.5; 95% CI 1.7-3.7). The LGA rate in FET babies was significantly different from natural conception babies (6.6% versus 3.2%, P = 0.012). This outcome was influenced by the transfer of frozen embryos (aOR 2.2; 95% CI 1.3-3.8) and by a high maternal weight (aOR 1.9; 95% CI 1.1-3.6). CONCLUSIONS: Maternal background and obstetric parameters are more likely to influence the SGA rate than fresh embryo transfer conception. FET conception could be associated with an increase in LGA rate.
Authors: Nakeisha A Lodge-Tulloch; Flavia T S Elias; Jessica Pudwell; Laura Gaudet; Mark Walker; Graeme N Smith; Maria P Velez Journal: BMC Pregnancy Childbirth Date: 2021-03-22 Impact factor: 3.007