Barbara Luke1, Morton B Brown2, Ethan Wantman3, Nina E Forestieri4, Marilyn L Browne5,6, Sarah C Fisher5, Mahsa M Yazdy7, Mary K Ethen7, Mark A Canfield8, Hazel B Nichols9, Sergio Oehninger10, Kevin J Doody11, Alastair G Sutcliffe12, Carrie Williams12, Michael L Eisenberg13, Valerie L Baker14, Caitlin R Sacha15, Philip J Lupo16. 1. Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, 965 Wilson Road, East Fee Hall, Room 628, East Lansing, MI, 48824, USA. lukeb@msu.edu. 2. Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA. 3. Redshift Technologies, Inc., New York, NY, USA. 4. Birth Defects Monitoring Program, State Center for Health Statistics, North Carolina Department of Health and Human Services, Raleigh, NC, USA. 5. Birth Defects Research Section, New York State Department of Health, Albany, NY, USA. 6. Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, NY, USA. 7. Massachusetts Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, MA, USA. 8. Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX, USA. 9. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA. 10. , Virginia Beach, USA. 11. Center for Assisted Reproduction, Bedford, TX, USA. 12. UCL Great Ormond Street Institute of Child Health, University College London, London, UK. 13. Division of Male Reproductive Medicine and Surgery, Department of Urology, Stanford University School of Medicine, Palo Alto, CA, USA. 14. Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 15. Massachusetts General Hospital Fertility Center and Harvard Medical School, Boston, MA, USA. 16. Epidemiology Program, Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TX, USA.
Abstract
PURPOSE: Excess embryos transferred (ET) (> plurality at birth) and fetal heartbeats (FHB) at 6 weeks' gestation are associated with reductions in birthweight and gestation, but prior studies have been limited by small sample sizes and limited IVF data. This analysis evaluated associations between excess ET, excess FHB, and adverse perinatal outcomes, including the risk of nonchromosomal birth defects. METHODS: Live births conceived via IVF from Massachusetts, New York, North Carolina, and Texas included 138,435 children born 2004-2013 (Texas), 2004-2016 (Massachusetts and North Carolina), and 2004-2017 (New York) were classified by ET and FHB. Major birth defects were reported by statewide registries within the first year of life. Logistic regression was used to estimate adjusted odds ratios (AORs) and 95% CIs of the risks of a major nonchromosomal birth defect, small-for-gestational age birthweight (SGA), low birthweight (LBW), and preterm birth (≤36 weeks), by excess ET, and excess ET + excess FHB, by plurality at birth (singletons and twins). RESULTS: In singletons with [2 ET, FHB =1] and [≥3 ET, FHB=1], risks [AOR (95% CI)] were increased, respectively, for major nonchromosomal birth defects [1.13 (1.00-1.27) and 1.18 (1.00-1.38)], SGA [1.10 (1.03-1.17) and 1.15 (1.05-1.26)], LBW [1.09 (1.02-1.13) and 1.17 (1.07-1.27)], and preterm birth [1.06 (1.00-1.12) and 1.14 (1.06-1.23)]. With excess ET + excess FHB, risks of all adverse outcomes except major nonchromosomal birth defects increased further for both singletons and twins. CONCLUSION: Excess embryos transferred are associated with increased risks for nonchromosomal birth defects, reduced birthweight, and prematurity in IVF-conceived births.
PURPOSE: Excess embryos transferred (ET) (> plurality at birth) and fetal heartbeats (FHB) at 6 weeks' gestation are associated with reductions in birthweight and gestation, but prior studies have been limited by small sample sizes and limited IVF data. This analysis evaluated associations between excess ET, excess FHB, and adverse perinatal outcomes, including the risk of nonchromosomal birth defects. METHODS: Live births conceived via IVF from Massachusetts, New York, North Carolina, and Texas included 138,435 children born 2004-2013 (Texas), 2004-2016 (Massachusetts and North Carolina), and 2004-2017 (New York) were classified by ET and FHB. Major birth defects were reported by statewide registries within the first year of life. Logistic regression was used to estimate adjusted odds ratios (AORs) and 95% CIs of the risks of a major nonchromosomal birth defect, small-for-gestational age birthweight (SGA), low birthweight (LBW), and preterm birth (≤36 weeks), by excess ET, and excess ET + excess FHB, by plurality at birth (singletons and twins). RESULTS: In singletons with [2 ET, FHB =1] and [≥3 ET, FHB=1], risks [AOR (95% CI)] were increased, respectively, for major nonchromosomal birth defects [1.13 (1.00-1.27) and 1.18 (1.00-1.38)], SGA [1.10 (1.03-1.17) and 1.15 (1.05-1.26)], LBW [1.09 (1.02-1.13) and 1.17 (1.07-1.27)], and preterm birth [1.06 (1.00-1.12) and 1.14 (1.06-1.23)]. With excess ET + excess FHB, risks of all adverse outcomes except major nonchromosomal birth defects increased further for both singletons and twins. CONCLUSION: Excess embryos transferred are associated with increased risks for nonchromosomal birth defects, reduced birthweight, and prematurity in IVF-conceived births.
Authors: Barbara Luke; Morton B Brown; Judy E Stern; David A Grainger; Nancy Klein; Marcelle Cedars Journal: J Reprod Med Date: 2010 Sep-Oct Impact factor: 0.142
Authors: Logan G Spector; Morton B Brown; Ethan Wantman; Gerard S Letterie; James P Toner; Kevin Doody; Elizabeth Ginsburg; Melanie Williams; Lori Koch; Maria J Schymura; Barbara Luke Journal: JAMA Pediatr Date: 2019-06-03 Impact factor: 16.193
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