Accepted Article
Article Type: Clinical Article CLINICAL ARTICLE
The effect of fertility treatment on adverse perinatal outcomes in women aged at least 40 years
Avi Harlev 1*, Asnat Walfisch 2, Eynan Oran 1, Iris Har-Vardi 1, Michael Friger 3, Eitan Lunenfeld 1, Eliahu Levitas 1
1
Fertility and IVF Unit, Department of Obstetrics and Gynecology, Soroka University
Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel 2
High Risk Pregnancy Unit, Department of Obstetrics and Gynecology, Soroka
University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel 3
Department of Epidemiology and Health Services Evaluation Faculty of Health
Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
*
Corresponding author: Avi Harlev
Fertility and IVF Unit, Recurrent pregnancy loss clinic, Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Tel.: +972 8 640 0111/+972 504 434 215; fax: +972 8 640 3057. E-mail address: [email protected].
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/ijgo.12345 This article is protected by copyright. All rights reserved.
Accepted Article
Presented in part at the 32nd Annual Meeting of the European Society of Human Reproduction and Embryology; July 3–6, 2016; Helsinki, Finland.
ABSTRACT Objective: To compare perinatal outcomes between spontaneous conception and assisted reproductive technologies (ART) among patients of advanced maternal age. Methods: The present retrospective study included data from singleton pregnancies of women aged at least 40 years who delivered between January 1, 1991, and December 31, 2013, at Soroka University Medical Center, Beer Sheva, Israel. Demographic, obstetric, and perinatal data were compared between pregnancies conceived with ART (in vitro fertilization [IVF] or ovulation induction) and those conceived spontaneously. Multiple regression models were used to define independent predictors of adverse outcomes. Results: A total of 8244 singleton pregnancies were included; 229 (2.8%) following IVF, 86 (1.0%) following ovulation induction, and 7929 (96.2%) were spontaneous. Preterm delivery (P or = 45 years). J Med Assoc Thai 2014;97(1): 1-6. [31]
Mack LR, Tomich PG: Gestational Diabetes: Diagnosis, Classification, and
Clinical Care. Obstet Gynecol Clin North Am 2017;44(2): 207-217.
This article is protected by copyright. All rights reserved.
Accepted Article
[32]
Gao X, Yan Y, Xiang S, Zeng G, Liu S, Sha T, et al.: The mutual effect of pre-
pregnancy body mass index, waist circumference and gestational weight gain on obesity-related adverse pregnancy outcomes: A birth cohort study. PLoS One 2017;12(6): e0177418. [33]
Most O, Langer O: Gestational diabetes: maternal weight gain in relation to fetal
growth, treatment modality, BMI and glycemic control. J Matern Fetal Neonatal Med 2012;25(11): 2458-2463. [34]
Langer O: From educated guess to accepted practice: the use of oral antidiabetic
agents in pregnancy. Clin Obstet Gynecol 2007;50(4): 959-971. [35]
Gepner Y, Bril N, Shelef I, Schwarzfuchs D, Serfaty D, Rein M, et al.: Higher
visceral adiposity is associated with an enhanced early thermogenic response to carbohydrate-rich food. Clin Nutr 2016;35(2): 422-427. [36]
Bluher M, Bashan N, Shai I, Harman-Boehm I, Tarnovscki T, Avinaoch E, et al.:
Activated Ask1-MKK4-p38MAPK/JNK stress signaling pathway in human omental fat tissue may link macrophage infiltration to whole-body Insulin sensitivity. J Clin Endocrinol Metab 2009;94(7): 2507-2515. [37]
Harlev A, Aricha-Tamir B, Shaco-Levy R, Tarnovscki T, Bashan N, Rudich A, et
al.: Macrophage infiltration and stress-signaling in omental and subcutaneous adipose tissue in diabetic pregnancies. J Matern Fetal Neonatal Med 2013. [38]
Harlev A, Wiznitzer A: New insights on glucose pathophysiology in gestational
diabetes and insulin resistance. Curr Diab Rep 2010;10(3): 242-247.
This article is protected by copyright. All rights reserved.
Accepted Article
[39]
Cakiroglu Y, Vural F, Vural B: The inflammatory markers in polycystic ovary
syndrome: association with obesity and IVF outcomes. J Endocrinol Invest 2016;39(8): 899-907. [40]
Liang PY, Diao LH, Huang CY, Lian RC, Chen X, Li GG, et al.: The pro-
inflammatory and anti-inflammatory cytokine profile in peripheral blood of women with recurrent implantation failure. Reprod Biomed Online 2015;31(6): 823-826. [41]
Raunig JM, Yamauchi Y, Ward MA, Collier AC: Placental inflammation and
oxidative stress in the mouse model of assisted reproduction. Placenta 2011;32(11): 852-858.
Figure 1 Proportion of pregnancies following different conception methods stratified by maternal age. Abbreviation: IVF, in vitro fertilization.
This article is protected by copyright. All rights reserved.
Accepted Article
Table 1 Maternal characteristics. a Variable In-vitro fertilization (n=229) Ethnicity Bedouin 26 (11.4) Jew 203 (88.6) Maternal age, y 41.32±1.35 Gravidity 1 2–4 ≥5 Parity
Ovulation induction (n=86)
Spontaneous pregnancy (n=7929)
8 (9) 78 (91) 41.34±1.20
3614 (45.6) 4315 (54.4) 41.20±1.20
P value
Article Type: Clinical Article CLINICAL ARTICLE
The effect of fertility treatment on adverse perinatal outcomes in women aged at least 40 years
Avi Harlev 1*, Asnat Walfisch 2, Eynan Oran 1, Iris Har-Vardi 1, Michael Friger 3, Eitan Lunenfeld 1, Eliahu Levitas 1
1
Fertility and IVF Unit, Department of Obstetrics and Gynecology, Soroka University
Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel 2
High Risk Pregnancy Unit, Department of Obstetrics and Gynecology, Soroka
University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel 3
Department of Epidemiology and Health Services Evaluation Faculty of Health
Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
*
Corresponding author: Avi Harlev
Fertility and IVF Unit, Recurrent pregnancy loss clinic, Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Tel.: +972 8 640 0111/+972 504 434 215; fax: +972 8 640 3057. E-mail address: [email protected].
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/ijgo.12345 This article is protected by copyright. All rights reserved.
Accepted Article
Presented in part at the 32nd Annual Meeting of the European Society of Human Reproduction and Embryology; July 3–6, 2016; Helsinki, Finland.
ABSTRACT Objective: To compare perinatal outcomes between spontaneous conception and assisted reproductive technologies (ART) among patients of advanced maternal age. Methods: The present retrospective study included data from singleton pregnancies of women aged at least 40 years who delivered between January 1, 1991, and December 31, 2013, at Soroka University Medical Center, Beer Sheva, Israel. Demographic, obstetric, and perinatal data were compared between pregnancies conceived with ART (in vitro fertilization [IVF] or ovulation induction) and those conceived spontaneously. Multiple regression models were used to define independent predictors of adverse outcomes. Results: A total of 8244 singleton pregnancies were included; 229 (2.8%) following IVF, 86 (1.0%) following ovulation induction, and 7929 (96.2%) were spontaneous. Preterm delivery (P or = 45 years). J Med Assoc Thai 2014;97(1): 1-6. [31]
Mack LR, Tomich PG: Gestational Diabetes: Diagnosis, Classification, and
Clinical Care. Obstet Gynecol Clin North Am 2017;44(2): 207-217.
This article is protected by copyright. All rights reserved.
Accepted Article
[32]
Gao X, Yan Y, Xiang S, Zeng G, Liu S, Sha T, et al.: The mutual effect of pre-
pregnancy body mass index, waist circumference and gestational weight gain on obesity-related adverse pregnancy outcomes: A birth cohort study. PLoS One 2017;12(6): e0177418. [33]
Most O, Langer O: Gestational diabetes: maternal weight gain in relation to fetal
growth, treatment modality, BMI and glycemic control. J Matern Fetal Neonatal Med 2012;25(11): 2458-2463. [34]
Langer O: From educated guess to accepted practice: the use of oral antidiabetic
agents in pregnancy. Clin Obstet Gynecol 2007;50(4): 959-971. [35]
Gepner Y, Bril N, Shelef I, Schwarzfuchs D, Serfaty D, Rein M, et al.: Higher
visceral adiposity is associated with an enhanced early thermogenic response to carbohydrate-rich food. Clin Nutr 2016;35(2): 422-427. [36]
Bluher M, Bashan N, Shai I, Harman-Boehm I, Tarnovscki T, Avinaoch E, et al.:
Activated Ask1-MKK4-p38MAPK/JNK stress signaling pathway in human omental fat tissue may link macrophage infiltration to whole-body Insulin sensitivity. J Clin Endocrinol Metab 2009;94(7): 2507-2515. [37]
Harlev A, Aricha-Tamir B, Shaco-Levy R, Tarnovscki T, Bashan N, Rudich A, et
al.: Macrophage infiltration and stress-signaling in omental and subcutaneous adipose tissue in diabetic pregnancies. J Matern Fetal Neonatal Med 2013. [38]
Harlev A, Wiznitzer A: New insights on glucose pathophysiology in gestational
diabetes and insulin resistance. Curr Diab Rep 2010;10(3): 242-247.
This article is protected by copyright. All rights reserved.
Accepted Article
[39]
Cakiroglu Y, Vural F, Vural B: The inflammatory markers in polycystic ovary
syndrome: association with obesity and IVF outcomes. J Endocrinol Invest 2016;39(8): 899-907. [40]
Liang PY, Diao LH, Huang CY, Lian RC, Chen X, Li GG, et al.: The pro-
inflammatory and anti-inflammatory cytokine profile in peripheral blood of women with recurrent implantation failure. Reprod Biomed Online 2015;31(6): 823-826. [41]
Raunig JM, Yamauchi Y, Ward MA, Collier AC: Placental inflammation and
oxidative stress in the mouse model of assisted reproduction. Placenta 2011;32(11): 852-858.
Figure 1 Proportion of pregnancies following different conception methods stratified by maternal age. Abbreviation: IVF, in vitro fertilization.
This article is protected by copyright. All rights reserved.
Accepted Article
Table 1 Maternal characteristics. a Variable In-vitro fertilization (n=229) Ethnicity Bedouin 26 (11.4) Jew 203 (88.6) Maternal age, y 41.32±1.35 Gravidity 1 2–4 ≥5 Parity
Ovulation induction (n=86)
Spontaneous pregnancy (n=7929)
8 (9) 78 (91) 41.34±1.20
3614 (45.6) 4315 (54.4) 41.20±1.20
P value
