Karoline Gundersen Sarmon1, Troels Eliasen2, Ulla Breth Knudsen3, Bjørn Bay4. 1. Institute of Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark. Electronic address: karolinesarmon@gmail.com. 2. Institute of Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark. 3. Institute of Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark; The Fertility Clinic, Horsens Regional Hospital, Horsens, Denmark; The Fertility Clinic, Aarhus University Hospital, Aarhus, Denmark. 4. Bay Gynækologisk Klinik, Aarhus, Denmark.
Abstract
OBJECTIVE: To identify the risk of stillbirth from in vitro types of assisted reproductive technologies compared with spontaneous conception (SC), limited to singleton births. DESIGN: Systematic literature search and search chaining on online databases: PubMed, Embase, and Scopus. SETTING: Not applicable. PATIENT(S): Singleton pregnancies from in vitro fertilization (IVF) or fertilization by IVF and intracytoplasmic sperm injection (IVF-ICSI). INTERVENTION(S): Not applicable. MAIN OUTCOME MEASURE(S): Adjusted odds ratio for stillbirth or prevalence of stillbirth in case-control groups of IVF/IVF-ICSI singletons and SCs, respectively, in matched studies. RESULT(S): A total of 19 studies were included, and study quality was mixed. Ten studies qualified for inclusion to the meta-analysis, which revealed a significantly increased risk of stillbirth in IVF/IVF-ICSI compared with that in SC (odds ratio [95% confidence interval]: 1.82 [1.37-2.42]), and there was no evidence of publication bias. CONCLUSION(S): In vitro fertilization and IVF-ICSI treatment increases the risk of stillbirth compared with natural conception. CLINICAL TRIAL REGISTRATION NUMBER: PROSPERO 216768.
OBJECTIVE: To identify the risk of stillbirth from in vitro types of assisted reproductive technologies compared with spontaneous conception (SC), limited to singleton births. DESIGN: Systematic literature search and search chaining on online databases: PubMed, Embase, and Scopus. SETTING: Not applicable. PATIENT(S): Singleton pregnancies from in vitro fertilization (IVF) or fertilization by IVF and intracytoplasmic sperm injection (IVF-ICSI). INTERVENTION(S): Not applicable. MAIN OUTCOME MEASURE(S): Adjusted odds ratio for stillbirth or prevalence of stillbirth in case-control groups of IVF/IVF-ICSI singletons and SCs, respectively, in matched studies. RESULT(S): A total of 19 studies were included, and study quality was mixed. Ten studies qualified for inclusion to the meta-analysis, which revealed a significantly increased risk of stillbirth in IVF/IVF-ICSI compared with that in SC (odds ratio [95% confidence interval]: 1.82 [1.37-2.42]), and there was no evidence of publication bias. CONCLUSION(S): In vitro fertilization and IVF-ICSI treatment increases the risk of stillbirth compared with natural conception. CLINICAL TRIAL REGISTRATION NUMBER: PROSPERO 216768.