title: Impact of infertility characteristics and treatment modalities on singleton pregnancies after assisted reproduction.
abstract: Obstetric and neonatal outcomes of assisted reproduction and control singletons were evaluated after taking into account treatment characteristics and infertility background. The elective single embryo transfer (eSET) group (n = 45) was compared with the compulsory single embryo transfer (cSET; n = 52), double embryo transfer (DET; n = 227) and control (n = 304) groups. Infertility-related prognostic factors for neonatal outcomes were also analysed. Data were collected with structured questionnaires at gestational week 20 and 8 weeks after delivery. Spontaneous onset of delivery was more typical of the eSET group than of cSET and DET groups (68.9 versus 52.0%, P = 0.02). Mean (+/-SD) gestation at birth (39.3 +/- 1.6 weeks) and mean birth weight (3,470 +/- 505 g) of eSET singletons were comparable with other assisted reproduction groups, but gestational duration was lower than in the eSET group than in the control group (39.9 +/- 1.4; P < 0.05). However, numbers of preterm births and low birth weight infants were similar between groups. History of induced abortion increased risk of preterm birth (OR 4.5 and 95% CI 1.2-17.1) in assisted reproduction singletons. A small though clinically unimportant difference in gestational age at birth and birth weight between assisted reproduction and control singletons was found regardless of the number of embryos transferred.
authors.affiliation: Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Haartmaninkatu 2, PL 140, 00029 Helsinki, Finland. pila.poikkeus@hus.fi
authors.forename: P
authors.initials: P
authors.lastname: Poikkeus
authors.forename: L
authors.initials: L
authors.lastname: Unkila-Kallio
authors.forename: S
authors.initials: S
authors.lastname: Vilska
authors.forename: L
authors.initials: L
authors.lastname: Repokari
authors.forename: R-L
authors.initials: RL
authors.lastname: Punamäki
authors.forename: A
authors.initials: A
authors.lastname: Aitokallio-Tallberg
authors.forename: J
authors.initials: J
authors.lastname: Sinkkonen
authors.forename: F
authors.initials: F
authors.lastname: Almqvist
authors.forename: M
authors.initials: M
authors.lastname: Tulppala
authors.forename: A
authors.initials: A
authors.lastname: Tiitinen
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015925:Cryopreservation; D004624:Embryo Transfer; D005260:Female; D005387:Finland; D006801:Humans; D007231:Infant, Newborn; D007246:Infertility / Q000628:therapy*; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology; D011256:Pregnancy Outcome; D011379:Prognosis; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects