title: Smaller fetal size in singletons after infertility therapies: the influence of technology and the underlying infertility.
abstract: OBJECTIVE
  To determine whether fetal size differences exist between matched fertile and infertile women and among women with infertility achieving pregnancy through various treatment modalities.
  
  
  METHODS
  Retrospective cohort study with propensity score analysis.
  
  
  METHODS
  Tertiary care center and affiliated community hospitals.
  
  
  METHODS
  1,246 fertile and 461 infertile healthy women with singleton livebirths over a 10-year period.
  
  
  METHODS
  Infertile women conceiving without medical assistance, with ovulation induction, or with in vitro fertilization.
  
  
  METHODS
  Birthweight; secondary outcomes included crown-rump length, second-trimester estimated fetal weight, and incidence of low birth weight and preterm delivery.
  
  
  RESULTS
  Compared with matched fertile women, infertile women had smaller neonates at birth (3,375 ± 21 vs. 3,231 ± 21 g) and more low-birth-weight infants (relative risk = 1.68, 95% confidence interval, 1.06, 2.67). Neonates conceived via ovulation induction were the smallest among the infertility subgroups compared with the neonates of fertile women (3,092 ± 46 vs. 3,397 ± 44 g). First-trimester fetal size was smaller in infertile versus fertile women (crown-rump length 7.9 ± 0.1 vs. 8.5 ± 0.1 mm). Within the infertility subgroups, no differences in fetal or neonatal size were found.
  
  
  CONCLUSIONS
  The inherent pathologic processes associated with infertility may have a larger impact on fetal growth than infertility therapies.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, Missouri 63108, USA. coopera@wustl.edu
authors.forename: Amber R
authors.initials: AR
authors.lastname: Cooper
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: O'Neill
authors.forename: Jenifer E
authors.initials: JE
authors.lastname: Allsworth
authors.forename: Emily S
authors.initials: ES
authors.lastname: Jungheim
authors.forename: Anthony O
authors.initials: AO
authors.lastname: Odibo
authors.forename: Diana L
authors.initials: DL
authors.lastname: Gray
authors.forename: Valerie S
authors.initials: VS
authors.lastname: Ratts
authors.forename: Kelle H
authors.initials: KH
authors.lastname: Moley
authors.forename: Randall R
authors.initials: RR
authors.lastname: Odem
mesh_terms: D000328:Adult; D001724:Birth Weight; D018568:Crown-Rump Length; D005260:Female; D047109:Fetal Development; D005317:Fetal Growth Retardation / Q000209:etiology* / Q000503:physiopathology; D020567:Fetal Weight; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007247:Infertility, Female / Q000503:physiopathology / Q000628:therapy*; D016014:Linear Models; D008923:Missouri; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D057216:Propensity Score; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors