Table 2 Levels and quality of the evidences available about the relationship between specific procedure for ARTs and risk of the main obstetric and perinatal adverse outcomes
Intervention | Outcome | Evidence | Risk measures | References | |
|---|---|---|---|---|---|
Levela | Qualityb | ||||
ART in singleton pregnancies | Compared to SCs, increased risk of: | ||||
Antepartum hemorrhage | 3 | Moderate | RR 2.11, 95 % CI 1.86 to 2.38 | Qin et al., 2016 [23] | |
Placental abruption | 3 | Moderate | RR 1.83, 95 % CI 1.49 to 2.24 | Qin et al., 2016 [23] | |
Postpartum hemorrhage | 3 | Moderate | RR 1.29, 95 % CI 1.06 to 1.57 | Qin et al., 2016 [23] | |
Peripartum hysterectomy | 3 | Moderate | aOR 5.98, 95 % CI 2.18 to 16.40 | Cromi et., 2016 [21] | |
GDM | 3 | High | RR 1.31, 95Â % CI 1.13 to 1.53 | Qin et al., 2016 [23] | |
PIH/PE | 3 | Moderate | RR 1.49, 95 % CI 1.39 to 1.59 | Pandey et al., 2012 [18] | |
PTB | 3 | High | RR 1.71, 95Â % CI 1.59 to 1.83 | Qin et al., 2016 [23] | |
Cesarean section | 3 | Moderate | RR 1.58, 95Â % CI 1.48 to 1.70 | Qin et al., 2016 [23] | |
Perinatal mortality | 3 | High | RR 1.64, 95Â % CI 1.41 to 1.90 | Qin et al., 2016 [23] | |
SGA | 3 | High | RR 1.35, 95 % CI 1.20 to 1.52 | Qin et al., 2016 [23] | |
ART in multiple pregnancies | Compared to SCs, increased risk of: | ||||
Premature rupture of membranes | 3 | Moderate | RR 1.20, 95 % CI 1.05 to 1.37 | Qin et al., 2015 [22] | |
PIH | 3 | Moderate | RR 1.11, 95 % CI 1.04 to 1.19 | Qin et al., 2015 [22] | |
GDM | 3 | Moderate | RR 1.78, 95 % CI 1.25 to 2.55 | Qin et al., 2015 [22] | |
PTB | 3 | Moderate | RR 1.08, 95 % CI 1.03 to 1.14 | Qin et al., 2015 [22] | |
LBW | 3 | Moderate | RR 1.04, 95 % CI 1.01 to 1.07 | Qin et al., 2015 [22] | |
Compared to SCs, no difference in: | |||||
Perinatal mortality (in dichorionic twins) | 3 | Low | RR 1.38, 95Â % CI 0.83 to 2.30 | Qin et al., 2016 [23] | |
Number of embryos transferred | SET vs. DET, no difference in: | ||||
PTB | 3 | Low | aOR 0.83, 95 % CI 0.64 to 1.06 | Pinborg et al., 2013 [9] | |
VTS in IVF/ICSI patients | Compared to VTS in NCs, increased risk of: | ||||
GDM | 3 | Low | aOR 3.0, 95 % CI 1.6 to 5.6 | Marton et al., 2016 [35] | |
IUGR | 3 | Low | aOR 3.0, 95 % CI 1.8 to 5.2 | Marton et al., 2016 [35] | |
PE | 3 | Low | aOR 1.6, 95 % CI 0.7 to 6.1 | Marton et al., 2016 [35] | |
LBW | 3 | Low | aOR 4.0, 95 % CI 1.8 to 7.1 | Marton et al., 2016 [35] | |
COH | CC-IVF vs. natural-cycle IVF, increased risk of: | ||||
LBW | 3 | Low | aOR 2.09, 95 % CI 1.34 to 3.33 | Nakashima et al., 2013 [43] | |
Hyperc vs. normal response, increased risk of: | |||||
LBW | 3 | Very Low | aOR 1.17, 95 % CI 1.05 to 1.30 | Sunkara et al., 2015 [49] | |
PTB | 3 | Very Low | aOR 1.15, 95 % CI 1.03 to 1.28 | Sunkara et al., 2015 [49] | |
Poord vs. normal response, no differences in: | |||||
LBW | 3 | Very Low | aOR 0.92, 95 % CI 0.79 to 1.06 | Sunkara et al., 2015 [49] | |
PTB | 3 | Very Low | aOR 0.88, 95 % CI 0.76 to 1.01 | Sunkara et al., 2015 [49] | |
Blastocyst state of ET | Compared to cleavage-state, increased risk of: | ||||
PTB | 3 | Very Low | aOR 1.39, 95 % CI 1.29 to 1.50 | Kalra et al., 2012 [61] | |
VPTB | 3 | Very Low | aOR 1.35, 95 % CI 1.13 to 1.61 | Kalra et al., 2012 [61] | |
LGA | 3 | Low | aOR 2.22, 95 % CI 1.14 to 4.34 | Mäkinen et al., 2013 [65] | |
Frozen-thawed ET | Compared to fresh-ET, reduced risk of: | ||||
LBW | 3 | Low | RR 0.69, 95 % CI 0.62 to 0.76 | Maheshwari et al., 2012 [81] | |
PTB | 3 | Low | RR 0.84, 95 % CI 0.78 to 0.90 | Maheshwari et al., 2012 [81] | |
SGA | 3 | Low | RR 0.45, 95 % CI 0.30 to 0.66 | Maheshwari et al.,2012 [81] | |
Compared to fresh-ET, increased risk of: | |||||
Placenta accreta | 3 | Low | aOR 3.16, 95 % CI 1.71 to 6.23 | Ishihara et al., 2014 [89] | |
PIH/PE | 3 | Low | aOR 1.58, 95 % CI 1.35 to 1.86 | Ishihara et al., 2014 [89] | |
LGA | 3 | Moderate | aOR 1.54, 95 % CI 1.31 to 1.81 | Pinborg et al., 2014 [98] | |
Macrosomia | 3 | Moderate | aOR 1.64, 95 % CI 1.26 to 2.12 | Pinborg et al., 2014 [98] | |
Vitrified oocytes | Compared to fresh oocytes, no differences in: | ||||
GDM | 3 | Very low | aOR 0.86, 95 % CI 0.56 to 1.31 | Cobo et al., 2014 [107] | |
PIH | 3 | Very low | aOR 0.84, 95 % CI 0.59 to 1.20 | Cobo et al., 2014 [107] | |
LBW | 3 | Very low | aOR 1.06, 95 % CI 0.78 to 1.42 | Cobo et al., 2014 [107] | |
PTB | 3 | Very low | aOR 0.70, 95 % CI 0.50 to 1.00 | Cobo et al., 2014 [107] | |
Vitrified embryos (blastocysts) | Compared to fresh-blastocysts, reduced risk of: | ||||
LBW | 3 | Very low | aRR 0.67, 95 % CI 0.58 to 0.78 | Li et al., 2014 [115] | |
PTB | 3 | Very low | aRR 0.86, 95 % CI 0.77 to 0.96 | Li et al., 2014 [117] | |
SGA | 3 | Very low | aRR 0.60, 95 % CI 0.53 to 0.68 | Li et al., 2014 [115] | |
IVM of oocytes | Compared to in vivo matured oocytes (vs. IVF and vs. ICSI), no differences in: | ||||
LBW | 3 | Very low | 3Â % vs. 10Â % vs. 14Â % (p: NS) | Buckett et al., 2007 [123] | |
PTB | 3 | Very low | 38Â % vs. 30Â % vs. 36Â % (p:NA) | Buckett et al., 2007 [123] | |
PGD | Blastocyst biopsy and frozen ET vs. cleavage-stage biopsy and fresh ET, increased risk of: | ||||
PIH | 4 | Very low | aOR 4.85, 95 % CI 1.34 to 17.56 | Jing et al., 2016 [136] | |
Oocyte donation | Compared to autologous oocyte in IVF singletons, increased risk of: | ||||
PIH | 3 | Moderate | aOR 2.30, 95 % CI 1.60 to 3.32 | Storgaard et al., 2016 [155] | |
PE | 3 | Moderate | aOR 2.11, 95 % CI 1.42 to 3.15 | Storgaard et al., 2016 [155] | |
PTB | 3 | Moderate | aOR 1.75, 95 % CI 1.39 to 2.20 | Storgaard et al., 2016 [155] | |
LBW | 3 | Moderate | aOR 1.53, 95Â % CI 1.16 to 2.01 | Storgaard et al., 2016 [155] | |
Postpartum hemorrhage | 3 | Low | aOR 2.40, 95 % CI 1.49 to 3.88 | Storgaard et al., 2016 [155] | |
Sperm donation | Singletons with donor semen vs.singletons with partner semen, increased risk of: | ||||
PE | 3 | Very low | 18.2 % vs. 0 % (p < 0.05) | Salha et al., 1999 [159] | |
Embryo donation | NA | Â | Â | Â | Â |
Gestational carrier | Surrogate singletons vs. control IVF-singleton pregnancies, no differences in: | ||||
PTB | 4 | Low | 0–11.5 % vs. 14 % (p:NA) | Söderström-Anttila et al., 2016 [162] | |
LBW | 3 | Low | 0–11.1 % vs. 13.6–14.0 % (p:NA) | Söderström-Anttila et al., 2016 [162] | |