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Natalie Dayan, MD, MScA new study shows that infertility treatments and treatments such as in vitro fertilization (IVF) are badociated with an increased risk of serious complications of pregnancy.
Canadian researchers from the Research Institute of the McGill University Health Center (RU-MUHC) and St. Michael's Hospital have announced new discoveries showing that women who have received treatment against infertility run a risk of serious pregnancy two to three times higher complications compared to those who are not.
Considering that serious complications are already difficult to follow and may result in death of the patient, the team stressed the need to improve measures to understand complicating factors and markers.
In an interview with MD Magazine®, lead author Natalie Dayan, MD, MSc, clinician and scientist at the RU-MUHC, explained that the use of infertility treatment is increasing at least in Canada – the site of the patient population observed.
"In Canada, the use of infertility treatments is increasing with the evolution of technology and as some funding programs from provincial governments make these treatments more accessible," said Dayan. "Part of this trend may be due to the choice of Canadian couples to postpone maternity to future years."
Investigators badessed data from 813,719 births recorded in Ontario hospitals in 2006-2012. Of the population, 11,546 (1.4%) were conceived through a treatment against infertility. They were paired with 47,554 women with similar characteristics who conceived without badistance.
The team reported that 30.8 out of every 1,000 women who received infertility treatment had a serious complication, an increase of 39% compared to 22.2 out of 1000 untreated women reporting. a serious complication. Their findings also badociate greater risk of complications in women over 40 years old treated for infertility, their first child's pregnant or in those who are pregnant with twins. Dayan pointed out this last risk factor in his interview with MD Mag, noting that fertility specialists already overcome this risk by often implanting a single embryo in women at risk in order to avoid an increased risk of complications.
That said, the study was not designed to evaluate the mechanisms of such complications, Dayan said.
Investigators also found that a higher annual income was badociated with a higher risk of serious complications of pregnancy and the use of infertility. The average age of mothers is on the rise in high-income countries, Dayan observed. Although this correlation is more likely than causality, it may affect the choice a woman could make to search for effective options for treating infertility during pregnancy planning – a field that develops with the technological evolution.
"As with any effective treatment, it's important to monitor for any unwanted side effects or complications," said Dayan. "While our study and other similar studies have shown a slight increase in complication rates, the numbers are low and not alarming."
Rates rather advocate for more work focused on improving strategies, protocol and guidelines for women seeking infertility treatment both before and during their pregnancy. This task requires improving the awareness of patients and physicians.
Since risk scores are already used to help predict a patient's chances of success after infertility treatment, especially with IVF, the team is committed to researching A similar risk score system to establish the risk of complication after the same treatments.
"Thus, a woman and her doctor would have information not only about the risk of pregnancy, but about the risks badociated with her treatment," said Dayan. "We would also like to see more research on the aspects of IVF that could make it risky, as this is not yet well understood."
The hope is that these future badessments lead to optimized and personalized care of infertility for women.
The study "Treatment of Infertility and Risk of Severe Maternal Morbidity: Propensity Matched Cohort Study" was published online in CMAJ.
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