Pregnancies conceived after IVF/ICSI face a greater risk of preterm delivery as compared
to natural conceived cohorts reports the results of meta-analysis published
recently in Journal Ultrasound in Obstetrics and Gynecology.
Earlier
studies have also documented an increased risk of having a premature baby in
couples who have conceived after IVF/ICSI, but whether this is a spontaneous
(SPTB) phenomenon or iatrogenic has not been studied.
A research
of literature identified 71 studies out of which 15 met the inclusion criteria,
and resulted in total sample size of 61,677births.
Statistical
analysis showed that SPTB occurred before 37 weeks in nearly 50% more
pregnancies conceived by IVF/ICSI (10.1%) than natural conception (5.5%) (odds
ratio 1.75; 95% CI 1.50-2.03). The corresponding rates before 34 weeks were
3.6% and 2.1% respectively.
Dr Paolo
Cavoretto of IRCCS San Raffaele Hospital in Milan, Italy, is one of the study
authors, and he opined that all pregnancies conceived with IVF/ICSI should undergo a
mid-trimester transvaginal cervical length evaluation.
If a short
cervix is diagnosed, intravaginal progesterone or cerclage should be considered
as per individual patient obstetric history.
The
researchers called for bigger studies in future, to explore in-depth the
mechanism behind SPTB and also differentiate between iatrogenic or indicated
PTB.
Media: Flickr.com
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