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in vitro fertilization (IVF)

Procedure: - no benefit to routine hysteroscopy before in vitro fertilization - no benefit to acupuncture during in vitro fertilization [12] Complications: - 35% incidence of multiple pregnancies (i.e. twins, triplets ...) with transfer of multiple embryos to counteract low rate of implantation - increased risk of preterm birth - increased risk of low-birth weight - increased risk of birth defects (odds ratio 1.3) [2] - preterm birth & multiple gestation associated with increased risk of mental retardation - intracytoplasmic sperm injection may be associated with increased risk of mental retardation & autism - no increased risk for developing cancer [13] - ovarian stimulation for IVF does not increase risk for breast cancer [7] - women with polycystic ovary syndrome have excess risk for ovarian hyperstimulation syndrome [9] - use of frozen embryo vs fresh embryo transfer reduces risk Notes: - single embryo transfers for women < 38 years of age reduces multiple birth rates, but not live birth rates [8] - test scores of children conceived by in vitro feritilization scored higher on standardized tests than their matched peers [3] - emotional distress does not seem to effect the chances of becoming pregnant [4] - in vitro fertilization may be successful after as many as 9 cycles [5] - clinical factors associated with a higher IVF live birth rate - age of the woman (< 30 years) - shorter duration of infertility (<3 years) - previous live birth - IVF cycle performed at a center with above average success - unexplained or anovulatory infertility - collection of more oocytes in stimulated cycle - use of intracytoplasmic sperm injection - development of blastocyst-stage embryos [10] - in ovulatory infertile women, conventional & 'freeze-all' in vitro fertilization - embryo transfer yielded similar live birth rates [11]

Related

infertility

Specific

intracytoplasmic sperm injection (ICSI) three-parent in vitro fertilization

General

assisted reproduction technology (ART)

References

  1. Journal Watch 25(2):15, 2005 Thurin A, Hausken J, Hillensjo T, Jablonowska B, Pinborg A, Strandell A, Bergh C. Elective single-embryo transfer versus double-embryo transfer in vitro fertilization. N Engl J Med. 2004 Dec 2;351(23):2392-402. PMID: 15575055
  2. Journal Watch 25(8):67, 2005 Hansen M, Bower C, Milne E, de Klerk N, Kurinczuk JJ. Assisted reproductive technologies and the risk of birth defects--a systematic review. Hum Reprod. 2005 Feb;20(2):328-38. Epub 2004 Nov 26. PMID: 15567881
  3. Mains L et al. Achievement test performance in children conceived by IVF. Hum Reprod 2010 Oct; 25:2605. PMID: 20716561
  4. Boivin J et al. Emotional distress in infertile women and failure of assisted reproductive technologies: Meta-analysis of prospective psychosocial studies. BMJ 2011 Feb 23; 342:d223. PMID: 21345903
  5. Smith AD, Tilling K, Nelson SM, Lawlor DA Live-Birth Rate Associated With Repeat In Vitro Fertilization Treatment Cycles. JAMA. 2015;314(24):2654-2662 PMID: 26717030 http://jama.jamanetwork.com/article.aspx?articleid=2478204 - Myers ER Repeated In Vitro Fertilization Cycles for Infertility JAMA. 2015;314(24):2627-2629 PMID: 26717028 http://jama.jamanetwork.com/article.aspx?articleid=2478181
  6. Smit JG et al Hysteroscopy before in-vitro fertilisation (inSIGHT): a multicentre, randomised controlled trial. Lancet. April 27, 2016 PMID: 27132052 http://thelancet.com/journals/lancet/article/PIIS0140-6736%2816%2900231-2/abstract - El-Toukhy T et al Hysteroscopy in recurrent in-vitro fertilisation failure (TROPHY): a multicentre, randomised controlled trial. Lancet. April 27, 2016 PMID: 27132053 http://thelancet.com/journals/lancet/article/PIIS0140-6736%2816%2900258-0/abstract - Pellicer A, Galliano D Hysteroscopy before IVF: can it improve outcomes? Lancet. April 27, 2016 PMID: 27132054 http://thelancet.com/journals/lancet/article/PIIS0140-6736%2816%2900549-3/abstract
  7. van den Belt-Dusebout AW, Spaan M, Lambalk CB et al Ovarian Stimulation for In Vitro Fertilization and Long-term Risk of Breast Cancer. JAMA. 2016;316(3):300-312 PMID: 27434442 http://jama.jamanetwork.com/article.aspx?articleid=2533505
  8. Mancuso AC et al. Elective single embryo transfer in women less than age 38 years reduces multiple birth rates, but not live birth rates, in United States fertility clinics. Fertil Steril 2016 Jul 1. PMID: 27376458 http://www.fertstert.org/article/S0015-0282(16)61346-8/abstract
  9. Chen ZJ et al. Fresh versus frozen embryos for infertility in the polycystic ovary syndrome. N Engl J Med 2016 Aug 11; 375:523 PMID: 27509101 http://www.nejm.org/doi/10.1056/NEJMoa1513873 - Coutifaris C. "Freeze only" - an evolving standard in clinical in vitro fertilization. N Engl J Med 2016 Aug 11; 375:577 PMID: 27509107 http://www.nejm.org/doi/10.1056/NEJMe1606213
  10. McLernon DJ et al. Predicting the chances of a live birth after one or more complete cycles of in vitro fertilisation: Population based study of linked cycle data from 113 873 women. BMJ 2016 Nov 16; 355:i5735 PMID: 27852632 Free full text http://www.bmj.com/content/355/bmj.i5735
  11. Shi Y, Sun Y, Hao C et al. Transfer of fresh versus frozen embryos in ovulatory women. N Engl J Med 2018 Jan 11; 378:126. PMID: 29320646 http://www.nejm.org/doi/10.1056/NEJMoa1705334 - Vuong LN, Dang VQ, Ho TM et al. IVF transfer of fresh or frozen embryos in women without polycystic ovaries. N Engl J Med 2018 Jan 11; 378:137 PMID: 29320655 http://www.nejm.org/doi/10.1056/NEJMoa1703768
  12. Smith CA, de Lacey S, Chapman M et al Effect of Acupuncture vs Sham Acupuncture on Live Births Among Women Undergoing In Vitro Fertilization. A Randomized Clinical Trial. JAMA. 2018;319(19):1990-1998. May 15, 2018 PMID: 29800212 https://jamanetwork.com/journals/jama/article-abstract/2681194
  13. D'Ambrosio A IVF Babies at No Increased Risk of Childhood Cancers. No associations seen with intracytoplasmic sperm injection or frozen embryo transfer, study found. MedPage Today July 2, 2021 https://www.medpagetoday.com/meetingcoverage/eshre/93423 - Spaan M et al Cancer risk in a nationwide cohort of children and young adults conceived by assisted reproductive technology. European Society of Human Reproduction and Embryology (ESHRE) 2021; Abstract O-077.