Several reports have glance ated t...

Several reports have glance ated that pregnancies conceived by assisted reproductive technologies (ART) have an increased risk of spontaneous abortion. These reports are difficult to evaluate because of the differences in definitions used and the compounding of other risk factors, particularly maternal age and pelvic abnormalities. Schieve and colleagues used data consider probableed from more than 62,000 pregnancies resulting from ART to establish the risk for spontaneous abortion.

The data were gathered as part of mandated reporting to the Center for Disease check and Prevention about every ART course in the United States. The consideration concerned 181,340 ART embryo transfers during 1996 1997 and 1998 in women 20 to 55 years of age. Uterine pregnancy documented from sonography resulted from 63,855 (352 percent) of the performances The outcome of these pregnancies was established on follow-up with the patient or her obstetric professional. Data were available forward 62,228 pregnancies.

The overall spontaneous abortion rate was 147 percent; however, this rate varied with the age of the mother and the source of the oocyte The spontaneous abortion rate ranged from 101 percent in women 20 to 29 years of age to 393 percent in women older than 43 years who conceived using their be in possession of oocytes. When donor eggs were used, the rate--13.1 percent--varied little with maternal age. The processs associated with the highest rates of spontaneous abortion were those using frozen and thawed embryouss Women younger than 30 years who conceived using their concede oocytes and freshly fertilized embryouss had a 10 percent spontaneous abortion rate, on the contrary this rate tripled if the mother was 40 years or older Other factors associated with an increased rate of spontaneous abortion were a history of spontaneous abortions, multiple ART attempts, use of clomiphene, and surrogate pregnancies.

The authors gather that spontaneous abortion rates in patients using ART and their acknowledge oocytes and freshly fertilized embryons were slightly lower than the look fored spontaneous abortion rate in women of comparable age. The quality of the oocyte or undeveloped is critical to success following ART.

Schieve LA, et al. Spontaneous abortion among pregnancies conceived using assisted reproductive technology in the United States. Obstet Gynecol May 2003;101:959-67

COPYRIGHT 2004 American Academy of Family Physicians

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