PGT pregnancies have a similar risk for post-partum complications as naturally conceived pregnancies. Issue 1 (January 2023)

• Record Type: Journal Article
• Authors: Srebnik, Naama; Sverdlik Kislasi, Yulia; Amosi-Victor, Danielle; Rotshenker-Olshinka, Keren; Eldar-Geva, Talia; Ben-Ami, Ido; Shonberger, Oshrat; Michaeli, Jennia; Grisaru-Granovsky, Sorina; Rotem, Reut
• Is Part Of: Reproductive biomedicine online. Volume 46:Issue 1(2023)
• Page Start: 189
• Page End: 195
• Publication Date: 2023-01
• Subjects: IVF -- PGT -- Post-partum complications -- Preimplantation genetic testing -- Third stage of labour; Human reproductive technology -- Periodicals; Human embryo -- Periodicals; Reproduction -- Periodicals; 616.692
• DOI: 10.1016/j.rbmo.2022.09.009
• Languages: English
• ISSNs: 1472-6483

Abstract

Abstract: Research question: Do preimplantation genetic testing (PGT) pregnancies have higher post-partum complications compared with naturally conceived pregnancies? Design: Retrospective cohort study conducted in 2008–2020 at the Shaare Zedek Medical Center (SZMC), including all patients aged 18–45 years old who conceived following PGT with a singleton live birth >24 weeks. Data were collected from computerized hospital databases and patient files. There were two control groups: (i) pregnancies following IVF-ICSI (intracytoplasmic sperm injection); (ii) four neighbourhood controls for each case delivery (two women delivered before and two after) of women with naturally conceived pregnancies. Results: Overall, 120 PGT, 779 IVF-ICSI and 3507 naturally conceived deliveries were included. Demographic variables were similar apart from slightly higher age in the PGT ( P = 0.003) and ICSI ( P = 0.002) groups (31.07 ± 4.38 PGT, 31.66 ± 5.03 ICSI, 28.77 ± 5.72 naturally conceived). Composite post-partum placental-related complications (manual lysis of placenta, revision of uterine cavity, haemoglobin drop ≥3 g/dl, post-partum haemorrhage, need for blood transfusion) were more prevalent in both the PGT and IVF-ICSI groups as opposed to naturally conceived (20.0% versus 18.9% versus 10.3%, respectively, P < 0.001, P = 0.007). In a multivariate regression model PGT was not found to be independently associated with composite post-partum placental-related complications (adjusted odds ratio [aOR] 1.44, 95% confidence interval [CI] 0.83–2.15), while IVF-ICSI pregnancies had increased risk (aOR 1.52, 95% CI 1.20–1.97) compared with natural conception. No difference was found between fresh and frozen cycles or between day 3 and day 5 embryo transfer. Conclusions: PGT pregnancies have a comparable risk of post-partum placental-related complications to naturally conceived pregnancies, unlike IVF-ICSI pregnancies. It is possible that infertility itself is the main mediator for post-partum complications in IVF-ICSI pregnancies.