Skip to main content

Advertisement

SpringerLink
Log in

Pregnancy complications, obstetric risks, and neonatal outcome in singleton and twin pregnancies after GIFT and IVF

  • Original Article
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

In vitro fertilization (IVF) and to a lower extent gamete intra-fallopian transfer (GIFT) have become routine infertility treatments in industrialized countries. Our purpose is to compare the obstetric and neonatal characteristics of singleton and twin pregnancies after GIFT and IVF with those conceived spontaneously.

Methods

This case-control study was conducted in a tertiary care medical center. The 322 singleton and 78 twin pregnancies after GIFT or IVF from 1991 through 1996 were evaluated and compared with each other, and with a control group that conceived spontaneously and matched for parity, maternal and gestational age. Statistical significance of differences was assessed by χ2 test or two-tailed Fisher exact test. Continuous variables were compared by the paired t-test.

Results

Pregnancy-induced hypertension (PIH) and vaginal bleeding were significantly more frequent maternal complications in the GIFT/IVF singleton groups compared to controls. In twin pregnancies the rate of cesarean sections, vaginal bleeding and preterm labor were more common after GIFT/IVF but did not reach statistical significance. Assisted reproduction was associated with low birth weight only in twin pregnancies when controlled for confounding variables, however perinatal outcome was comparable. There was no significant difference in the outcome measures between GIFT and IVF pregnancies.

Conclusion

After controlling for parity, maternal and gestational age, singleton pregnancies conceived by GIFT/IVF are at increased obstetrical risk, however the perinatal outcome is comparable despite a lower average birth weight.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Agustsson T, Geirsson RT, Mires G (1997) Obstetric outcome of natural and assisted conception twin pregnancies is similar. Acta Obstet Gynecol Scand 76:45–49

    Article  CAS  PubMed  Google Scholar 

  2. Bayerische Perinatalerhebung [Bavarian Perinatal Registry] (1995) Bayerische Landesärztekammer, Munich

  3. Bernasko J, Lynch L, Lapinski R, Berkowitz RL (1997) Twin pregnancies conceived by assisted reproductive techniques: maternal and neonatal outcomes. Obstet Gynecol 89:368–372

    Article  CAS  PubMed  Google Scholar 

  4. Dhont M, De Sutter P, Ruyssinck G, Martens G, Bekaert A (1999) Perinatal outcome of pregnancies after assisted reproduction: a case-control study. Am J Obstet Gynecol 181:688–695

    Article  CAS  PubMed  Google Scholar 

  5. Doyle P, Beral V, Maconochie N (1992) Preterm delivery, low birthweight and small-for-gestational-age in liveborn singleton babies resulting from in-vitro fertilization. Hum Reprod 7:425–428

    CAS  PubMed  Google Scholar 

  6. Fitzsimmons BP, Bebbington MW, Fluker MR (1998) Perinatal and neonatal outcomes in multiple gestations: assisted reproduction versus spontaneous conception. Am J Obstet Gynecol 179:1162–1167

    Article  CAS  PubMed  Google Scholar 

  7. Goldman JA, Ashkenazi J, Ben-David M, Feldberg D, Dicker D, Voliovitz I (1988) First trimester bleeding in clinical IVF pregnancies. Hum Reprod 3:807–809

    CAS  PubMed  Google Scholar 

  8. Isaksson R, Gissler M, Tiitinen A (2002) Obstetric outcome among women with unexplained infertility after IVF: a matched case-control study. Hum Reprod 17:1755–1761

    Article  PubMed  Google Scholar 

  9. Koivurova S, Hartikainen AL, Gissler M, Hemminki E, Sovio U, Jarvelin MR (2002) Neonatal outcome and congenital malformations in children born after in-vitro fertilization. Hum Reprod 17:1391–1398

    Article  PubMed  Google Scholar 

  10. Koudstaal J, Bruinse HW, Helmerhorst FM, Vermeiden JP, Willemsen WN, Visser GH (2000) Obstetric outcome of twin pregnancies after in-vitro fertilization: a matched control study in four Dutch university hospitals. Hum Reprod 15:935–940

    Article  CAS  PubMed  Google Scholar 

  11. Maman E, Lunenfeld E, Levy A, Vardi H, Potashnik G (1998) Obstetric outcome of singleton pregnancies conceived by in vitro fertilization and ovulation induction compared with those conceived spontaneously. Fertil Steril 70:240–245

    Article  CAS  PubMed  Google Scholar 

  12. McFaul PB, Patel N, Mills J (1993) An audit of the obstetric outcome of 148 consecutive pregnancies from assisted conception: implications for neonatal services. Br J Obstet Gynaecol 100:820–825

    Article  CAS  PubMed  Google Scholar 

  13. McMahon CA, Ungerer JA, Beaurepaire J, Tennant C, Saunders D (1997) Anxiety during pregnancy and fetal attachment after in-vitro fertilization conception. Hum Reprod 12:176–182

    Article  CAS  PubMed  Google Scholar 

  14. Moise J, Laor A, Armon Y, Gur I, Gale R (1998) The outcome of twin pregnancies after IVF. Hum Reprod 13:1702–1705

    Article  CAS  PubMed  Google Scholar 

  15. Nolte E, Brand A, Koupilova I, McKee M (2000) Neonatal and postneonatal mortality in Germany since unification. J Epidemiol Community Health 54:84–90

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Nygren KG, Andersen AN (2002) Assisted reproductive technology in Europe, 1999. Results generated from European registers by ESHRE. Hum Reprod 17:3260–3274

    Article  CAS  PubMed  Google Scholar 

  17. Olivennes F, Rufat P, Andre B, Pourade A, Quiros MC, Frydman R (1993) The increased risk of complication observed in singleton pregnancies resulting from in-vitro fertilization (IVF) does not seem to be related to the IVF method itself. Hum Reprod 8:1297–1300

    CAS  PubMed  Google Scholar 

  18. Reubinoff BE, Samueloff A, Ben-Haim M, Friedler S, Schenker JG, Lewin A (1997) Is the obstetric outcome of in vitro fertilized singleton gestations different from natural ones? A controlled study. Fertil Steril 67:1077–1083

    Article  CAS  PubMed  Google Scholar 

  19. Tallo CP, Vohr B, Oh W, Rubin LP, Seifer DB, Haning RV Jr (1995) Maternal and neonatal morbidity associated with in vitro fertilization. J Pediatr 127:794–800

    Article  CAS  PubMed  Google Scholar 

  20. Tan SL, Doyle P, Campbell S et al (1992) Obstetric outcome of in vitro fertilization pregnancies compared with normally conceived pregnancies. Am J Obstet Gynecol 167:778–784

    Article  CAS  PubMed  Google Scholar 

  21. Tough SC, Greene CA, Svenson LW, Belik J (2000) Effects of in vitro fertilization on low birth weight, preterm delivery, and multiple birth. J Pediatr 136:618–622

    Article  CAS  PubMed  Google Scholar 

  22. Verlaenen H, Cammu H, Derde MP, Amy JJ (1995) Singleton pregnancy after in vitro fertilization: expectations and outcome. Obstet Gynecol 86:906–910

    Article  CAS  PubMed  Google Scholar 

  23. Wang JX, Clark AM, Kirby CA et al (1994) The obstetric outcome of singleton pregnancies following in-vitro fertilization/gamete intra-fallopian transfer. Hum Reprod 9:141–146

    CAS  PubMed  Google Scholar 

Download references

Acknowledgement

This article is dedicated to Prof. Dr. H.-G. Hillemanns, F.R.C.O.G., on the occasion of his 80th birthday.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University Munich-Grosshadern, 81377, Munich, Germany

    Robert Ochsenkühn, Monika Gurtner, Alexander Strauss, Hermann Hepp & Peter Hillemanns

  2. Division of Neonatology, University Munich-Grosshadern, 81377, Munich, Germany

    Andreas Schulze

  3. Department of Gynecological Endocrinology and Reproductive Medicine, University of Heidelberg, Heidelberg, Germany

    Thomas Strowitzki

Authors
  1. Robert Ochsenkühn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas Strowitzki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Monika Gurtner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alexander Strauss
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Andreas Schulze
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hermann Hepp
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Peter Hillemanns
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert Ochsenkühn.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ochsenkühn, R., Strowitzki, T., Gurtner, M. et al. Pregnancy complications, obstetric risks, and neonatal outcome in singleton and twin pregnancies after GIFT and IVF. Arch Gynecol Obstet 268, 256–261 (2003). https://doi.org/10.1007/s00404-003-0518-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-003-0518-5

Keywords

Search

Navigation