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. 2022 Oct;3(4):242-255.
doi: 10.1016/j.xfnr.2022.06.003. Epub 2022 Jul 5.

Assisted Reproductive Technology or Infertility: What underlies adverse outcomes? Lessons from the Massachusetts Outcome Study of Assisted Reproductive Technology

Judy E Stern  1 , Leslie V Farland  2 , Sunah S Hwang  3 , Dmitry Dukhovny  4 , Charles C Coddington  5 , Howard J Cabral  6 , Stacey A Missmer  7 , Eugene Declercq  8 , Hafsatou Diop  9
Affiliations

Assisted Reproductive Technology or Infertility: What underlies adverse outcomes? Lessons from the Massachusetts Outcome Study of Assisted Reproductive Technology

Judy E Stern et al. F S Rev. 2022 Oct.

Abstract

Numerous studies have demonstrated that assisted reproductive technology (ART: defined here as including only in vitro fertilization and related technologies) is associated with increased adverse pregnancy, neonatal, and childhood developmental outcomes, even in singletons. The comparison group for many had often been a fertile population that conceived without assistance. The Massachusetts Outcome Study of Assisted Reproductive Technology (MOSART) was initiated to define a subfertile population with which to compare ART outcomes. Over more than 10 years, we have used the MOSART database to study pregnancy abnormalities and delivery complications but also to evaluate ongoing health of women, infants, and children. This article will review studies from MOSART in the context of how they compare with those of other investigations. We will present MOSART studies that identified the influence of ART and subfertility/infertility on adverse pregnancy (pregnancy hypertensive disorder, gestational diabetes, placental abnormality) and delivery (preterm birth, low birthweight) outcomes as well as on maternal and child hospitalizations. We will provide evidence that although subfertility/infertility increases the risk of adverse outcomes, there is additional risk associated with the use of ART. Studies exploring the contribution of placental abnormalities as one factor adding to this increased ART-associated risk will be described.

Keywords: assisted reproductive technology (ART); child health; maternal health; placental abnormalities; preterm birth.

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Conflict of interest statement

Conflicts of interest: All authors’ institutions received support and travel funds from one or both grants. There are no other conflicts of interest.

Figures

Figure 1:
Figure 1:
Massachusetts Outcome Study of Assisted Reproductive Technology (MOSART) Schema
Figure 2a:
Figure 2a:
Adverse Outcomes Increased in Subfertile/Infertile and ART Groups
Figure 2b:
Figure 2b:
Adverse Outcomes Increased in ART over Subfertile/Infertile Groups
See this image and copyright information in PMC

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