Similar perinatal outcomes observed amongst conception via natural and assisted reproductive means

1. In this prospective population-based study, the likelihood of becoming pregnant or fathering a child was lower for those conceived via assisted reproductive technologies (ART) compared to natural conception, though the rates of perinatal complications were similar between both groups. 

Evidence Rating Level: 2 (Good)

Little is known regarding the fertility rates and pregnancy outcomes of people born via artificial reproductive technology (ART). In this prospective population-based study, the Medical Birth Registry of Norway was used to collect data on people born in Norway between 1984 and 2002. 531,015 liveborn girls and 561,136 liveborn boys are included in this registry, with 4763 girls and 5083 boys conceived via ART. ART was defined as the use of in vitro fertilization and embryo transfer. The study assessed the likelihood of becoming pregnant or fathering a child, as well as several pregnancy complications and outcomes, including the use of ART, hypertensive disorders of pregnancy and pre-eclampsia, birth weight, placental weight, preterm birth, gestational age, delivery by cesarean section, congenital malformations, low 5 minute Apgar score, transfer to NICU, and offspring sex. The likelihood of having a registered pregnancy was lower in the ART group compared to the non-ART group, with a minimally adjusted hazard ratio of 0.71 (95% CI 0.65-0.77). Similarly, the likelihood of fathering a child was lower for those conceived via ART, with an unadjusted hazard ratio of 0.79 (95% CI 0.71-0.87). Neonates of women conceived by ART had an increased risk of a low 5-minute Apgar score, with an adjusted odds ratio of 1.86 (95% CI 1.20-2.89), and decreased likelihood of male sex, with an odds ratio of 0.79 (95% CI 0.67-0.93). For all other pregnancy complications and outcomes assessed, there was no significant difference between both groups. Overall, this study determined that those conceived via ART were less likely to have a registered pregnancy or father a child, but further research is needed to fully understand the fertility differences between these two groups. As well, this study determined that there is little difference in pregnancy outcomes or rates of complications for those conceived via ART compared to natural conception. However, further research is needed to determine why the risk of having a neonate with a low 5-minute Apgar score is greater for those conceived via ART.

Click to read the study in BMJ

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