Obstetric outcomes and congenital abnormalities after in vitro maturation, in vitro fertilization, and intracytoplasmic sperm injection.
OBJECTIVE
To compare obstetric outcome and congenital abnormalities in pregnancies conceived after in vitro maturation (IVM), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI) with those in spontaneously conceived controls.


METHODS
Data were collected from the McGill Obstetrics and Neonatal Database (MOND). All children were examined and classified in a standard manner. Final data were reviewed 12 months after delivery. Pregnancies by IVM, IVF, and ICSI were compared with those of age- and parity-matched controls. Congenital abnormality, gestational age, birth weight, Apgar scores, cord pH, growth restriction, pregnancy complications, mode of delivery, and multiple pregnancy were compared.


RESULTS
A total of 432 children were born from 344 pregnancies after assisted reproductive technology (ART) during the study period (IVM 55, IVF 217, ICSI 160). The observed odds ratios (ORs) for any congenital abnormality were 1.42 (95% confidence interval [CI] 0.52-3.91) for IVM, 1.21 (95% CI 0.63-2.62) for IVF, and 1.69 (95% CI 0.88-3.26) for ICSI. Twin pregnancy (IVM 21%, IVF 20%, ICSI 17%) and triplet pregnancy (IVM 5%, IVF 3%, ICSI 3%) were higher than those in controls (1.7% twins and 0% triplets) (P<.001). Cesarean delivery rates were higher after ART, even in singleton pregnancies (IVM 39%, IVF 36%, ICSI 36%; controls: 26.3%) (P<.05). Apgar scores, cord pH, growth restriction, and pregnancy complications were comparable in all groups.


CONCLUSIONS
All ART pregnancies are associated with an increased risk of multiple pregnancy, cesarean delivery, and congenital abnormality. Compared with IVF and ICSI, IVM is not associated with any additional risk.
Buckett
William M
WM
Department of Obstetrics and Gynecology, McGill University, Royal Victoria Hospital, Montréal, Canada. william.buckett@muhc.mcgill.ca
Chian
Ri-Cheng
RC
Holzer
Hananel
H
Dean
Nicola
N
Usher
Robert
R
Tan
Seang Lin
SL
D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects; D006801:Humans; D007231:Infant, Newborn; D009865:Oocytes / Q000502:physiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D011792:Quebec / Q000453:epidemiology; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects