Although previous research has linked assisted reproductive therapies (ART) with an increased risk for serious birth complications including stillbirth, preterm birth, low birth weight, and neonatal death, limited data exists on the rates of maternal complications associated with the fertility procedures. Now a new study published in the journal JAMA concludes that autologous and donor-assisted reproductive technology procedures were associated with low complication risks within the United States between 2000 and 2011.
The use of ART continues to increase in the United States and throughout the world. In an effort to improve the safety of the procedures for women, stimulation protocols have become less aggressive, egg retrieval has transitioned from laparoscopic to transvaginal, and overall pregnancy rates have improved.
For the present study, researchers led by Jennifer F. Kawwass, M.D., of the Emory University School of Medicine in Atlanta examined the incidence of maternal complications associated with ART to evaluate the safety. The researchers examined data on patient and donor complications in fresh ART cycles using the U.S. Centers for Disease Control and Prevention National ART Surveillance System (NASS), a federally mandated reporting system.
Maternal complications reported included infection, hemorrhage requiring transfusion, moderate or severe ovarian hyperstimulation syndrome (OHSS), medication adverse event, anesthetic complication, hospitalization, and patient death within twelve weeks of stimulation, among others. Complications considered for the study occurred within twelve weeks of cycle stimulation.
Among the 1,135,206 autologous cycles, or cycles in which a woman uses her own egg, the most common maternal complications included OHSS (peak of 153.5 per 10,000 autologous cycles) and hospitalizations (34.8 per 10,000). The rates of other complications remained below 10 per 10,000 cycles.
Additionally, the rates of medication adverse events and hospitalizations decreased from 2000 to 2011.
Of the total 58 maternal deaths to occur among the participants, stimulationrelated causes accounted for 18 while 40 maternal deaths occurred prior to birth. The maternal death rate ranged between 1.6 per 100,000 ARTconceived live births in 2008 to 14.2 in 2004.
Maternal complications following donor-assisted ART cycles occurred less frequently and did not show any significant trend. No donor deaths occurred, but 13 maternal deaths occurred prior to birth among the egg donor recipients.
Overall, assisted reproductive therapies appear safe for mothers, with low rates of maternal complications occurring.
Conclude the researchers, “Increased awareness of the most common complication, OHSS, may prompt additional study to characterize predictors of this and other adverse events to inform the development of effective approaches necessary to decrease complication occurrence.”
However, not all experts agree on the use of ART. For example team of experts from the Centre for Reproductive Medicine at the University of Amsterdam in the Netherlands recently stated that in vitro fertilization (IVF), an ART, may be overused and that the risks of the treatment outweigh the benefits.
References
Study Finds Low Rate of Complications with Assisted Reproductive Technology Procedures: http://www.medicalnewstoday.com/releases/287713.php
Safety of Assisted Reproductive Technology in the United States, 2000-2011: http://jama.jamanetwork.com/article.aspx?articleid=2088842
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