Assisted Reproductive Technology or Infertility: What underlies adverse outcomes? Lessons from the Massachusetts Outcome Study of Assisted Reproductive Technology.
Assisted Reproductive Technology or Infertility: What underlies adverse outcomes? Lessons from the Massachusetts Outcome Study of Assisted Reproductive Technology.
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DOI：
10.1016/j.xfnr.2022.06.003
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发表时间：
2022-10
期刊：
影响因子：
--
通讯作者：
Diop H
中科院分区：
文献类型：
--
作者：
Stern JE;Farland LV;Hwang SS;Dukhovny D;Coddington CC;Cabral HJ;Missmer SA;Declercq E;Diop H
大量研究表明，辅助生殖技术（ART：此处定义为仅包括体外受精和相关技术）与不良妊娠、新生儿和儿童发育结果的增加有关，即使对于单胎也是如此。对许多人来说，对照组往往是在没有帮助的情况下怀孕的生育人群。马萨诸塞州辅助生殖技术结果研究 (MOSART) 的启动是为了定义生育力低下的人群，并与之比较 ART 的结果。十多年来，我们一直使用 MOSART 数据库来研究妊娠异常和分娩并发症，同时评估妇女、婴儿和儿童的持续健康状况。本文将回顾 MOSART 的研究，并与其他研究进行比较。我们将介绍 MOSART 研究，这些研究确定了 ART 和生育力低下/不孕症对不良妊娠（妊娠高血压疾病、妊娠糖尿病、胎盘异常）和分娩（早产、低出生体重）结局以及母婴住院的影响。我们将提供证据表明，尽管生育力低下/不孕症会增加不良后果的风险，但使用 ART 还会带来额外的风险。将描述探索胎盘异常作为增加 ART 相关风险的一个因素的研究。
Numerous studies have demonstrated that assisted reproductive technology (ART: defined here as including only in vitro fertilization and related technologies) is associated with increased adverse pregnancy, neonatal, and childhood developmental outcomes, even in singletons. The comparison group for many had often been a fertile population that conceived without assistance. The Massachusetts Outcome Study of Assisted Reproductive Technology (MOSART) was initiated to define a subfertile population with which to compare ART outcomes. Over more than 10 years, we have used the MOSART database to study pregnancy abnormalities and delivery complications but also to evaluate ongoing health of women, infants, and children. This article will review studies from MOSART in the context of how they compare with those of other investigations. We will present MOSART studies that identified the influence of ART and subfertility/infertility on adverse pregnancy (pregnancy hypertensive disorder, gestational diabetes, placental abnormality) and delivery (preterm birth, low birthweight) outcomes as well as on maternal and child hospitalizations. We will provide evidence that although subfertility/infertility increases the risk of adverse outcomes, there is additional risk associated with the use of ART. Studies exploring the contribution of placental abnormalities as one factor adding to this increased ART-associated risk will be described.
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2.3
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