Outcome of Pregnancies Conceived with Ivf and Icsi Depending on Age Factor

Abstract

INTRODUCTION: Infertility, a reproductive health condition prevalent among one in every four couples in the developing countries, is a neglected problem.In this era of exponential industrialization and global changes, lifestyle disorders like infertility are on the ri se. It is estimatedthat infertility affects 8 to 12 per cent of couples worldwide. overall IVF pregnancies are often seen as risky mainly due to multiple gestations. However, even singletonART pregnancies are associated with increased incidences of preterm birth, low birth weight, small-for-gestational-age (SGA) infants, and obstetric complications such as preeclampsia, placental abruption, and placenta praevia. While there are many studies that compare pregnancies after assisted reproductive techniques with spontaneously conceived pregnancies, fewer data are available that evaluate the differences between IVF and ICSI-conceived pregnancies. The aim of our study was to compare adversepregnancy outcomes in IVF and ICSI cases and how they vary depending on age factor. METHODS: This retrospective cohort study was conducted at Radhakrishna multispeciality hospital and IVF center, Bangalore during January 2013 to January 2019. A total of 667 of which 434 were IVF and 233 ICSI cases were done. 263 cases were pregnancy positive out of which 149cases underwent conventional IVF and 114 cases underwent ICSI. These cases were divided into three groups depending upon age factor. Outcome variables included maternal parameters: i.e., age; gravity;duration of infertility, pregnancy complications such as abortions, ectopic pregnancy, multiple pregnancies, pregnancy-induced hypertension, preeclampsia, prematurerupture of membranes, gestational diabetes mellitus, IUGR and preterm labour; antepartum hemorrhage and fetal parameters: i.e., gestational age; low and very low birth weight,meconium aspiration syndromeand need for NICU admission. RESULTS: In the study among those who had IVF pregnancy, there was no significant association between causes and Age distribution. however, a greater number of ICSI cases were done for male factor infertility. In IVF group, there was significant difference in Biochemical Pregnancy, Gestational DM, Pre-Term Labour, Oligo Hydramnios and Poly Hydramnios with respect to age distribution. I.e., all the above-mentioned complications were significantly high in mothers in the age group 30 to 40 years compared to other age groups. There was no significant difference in other complications with respect to age distribution. In ICSI group, there was significant difference in Biochemical Pregnancy with respect to age distribution. I.e., Biochemical Pregnancy were significantly high in mothers in the age group 30 to 40 years compared to other age groups. In the study there was significant difference in Preterm birth and NICU admission in IVF group with respect to age distribution. I.e., Preterm birth and NICU admission were highest in the age group 30 to 40 years mother. CONCLUSION: Women who conceived with IVF and ICSI were at higher risk of maternal and perinatal complications particularly with age group 30-40 years. There was significant increase in multiple pregnancies, gestational diabetes and preterm labour and NICU admission in IVF group. Hence with proper diagnosis, stimulation protocol and with single embryo transfer can reduce the risk of multiple birthand further perinatal complications.