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assisted reproduction technology (ART)

Indications: - infertility - other Methods: 1) intracytoplasmic sperm injection (ICSI) 2) in vitro fertilization 3) use of clomiphene citrate 4) GnRH agonist versus GnRH antagonist protocols [8] 5) spindle nuclear transfer Complications: 1) preeclampsia (2-fold risk) 2) major birth defects (2-fold risk) ICSI 3) low birth-weight infants (2.6 fold) risk 4) cerebral palsy (3.7-fold risk) 5) developmental delay (4-fold risk) 6) multiple gestations 7) premature labor & delivery - abruptio placenta (2.4-fold risk) [2] 8) placenta previa (6.0-fold risk) [2] 9) preeclampsia (2.7-fold risk) [2] 10) C-section (2.3-fold risk) [2] 11) genetic imprinting errors 12) possibly mood changes [8] 13) NO increased risk of [2] a) congenital malformation b) aneuploidy c) overall cancer [7] * Most children born via ART are entirely normal * ref [4] reports lower risks * ~60% of women have a live birth [5] * with autologous oocytes, birth rates decline with increasing maternal age [5] * with donor oocytes, birth rates are > 60%, regardless of patient age [5] * best outcomes occur when fewer embryos are transferred [6] Notes: - pesticides on fruits & vegetables may diminish success of infertility treatment with assisted reproduction technology [9]

Related

labor & delivery

Specific

3-donor embryo artificial insemination in vitro fertilization (IVF) spindle nuclear transfer

General

fertility treatment

References

  1. Journal Watch 22(8):66, 2002 Lynch A etal, Obstet Gynecol 99:445, 2002 Hansen M et al N Engl J Med 346:725, 2002 Schieve LA et al, N Engl J Med 346:731, 2002 http://content.nejm.org/cgi/content/abstract/346/10/731 Sromberg B et al, Lancet 359:461, 2002
  2. Shevell T, Malone FD, Vidaver J, Porter TF, Luthy DA, Comstock CH, Hankins GD, Eddleman K, Dolan S, Dugoff L, Craigo S, Timor IE, Carr SR, Wolfe HM, Bianchi DW, D'Alton ME. Assisted Reproductive Technology and Pregnancy Outcome. Obstet Gynecol. 2005 Nov;106(5):1039-1045. PMID: 16260523
  3. Sutcliffe AG et al, Assisted reproductive therapies and imprinting disorders - A preliminary British survey Hum Reprod 2006; 21:1009 PMID: 16361294
  4. Davies MJ et al Reproductive Technologies and the Risk of Birth Defects N Engl J Med May 5, 2012 PMID: 22559061 http://www.nejm.org/doi/full/10.1056/NEJMoa1008095
  5. Luke B et al Cumulative Birth Rates with Linked Assisted Reproductive Technology Cycles N Engl J Med 2012; 366:2483-2491 Not yet indexed in PubMmed http://www.nejm.org/doi/full/10.1056/NEJMoa1110238
  6. Hansen M et al. Assisted reproductive technology and major birth defects in Western Australia. Obstet Gynecol 2012 Oct; 120:852. PMID: 22996103 - Joshi N et al. Trends and correlates of good perinatal outcomes in assisted reproductive technology. Obstet Gynecol 2012 Oct; 120:843. PMID: 22996102
  7. Williams CL et al. Cancer risk among children born after assisted conception. N Engl J Med 2013 Nov 7; 369:1819 PMID: 24195549 http://www.nejm.org/doi/full/10.1056/NEJMoa1301675
  8. Stenbek DS et al. Mental distress and personality in women undergoing GnRH agonist versus GnRH antagonist protocols for assisted reproductive technology. Hum Reprod 2015 Jan; 30:103 PMID: 25398970 http://humrep.oxfordjournals.org/content/30/1/103
  9. Chiu YH, Williams PL, Gillman MW et al Association Between Pesticide Residue Intake From Consumption of Fruits and Vegetables and Pregnancy Outcomes Among Women Undergoing Infertility Treatment With Assisted Reproductive Technology. JAMA Intern Med. Published online October 30, 2017 PMID: 29084307 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2659557 - Landrigan PJ. Pesticides and Human Reproduction. JAMA Intern Med. Published online October 30, 2017 PMID: 29084335 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2659554