In a nutshell
This study investigated the connections between fertility issues in women and pregnancy outcomes in patients who needed help to conceive, and in patients who conceived naturally. The time it takes to get pregnant was identified as an important risk factor for poor pregnancy outcomes. Advanced maternal age, and maternal obesity also had a negative effect on pregnancy outcomes.
Infertility is usually defined as the failure to become pregnant after 12 months of regular unprotected sex. It is a common problem, affecting at least one in six couples. The time it takes to get pregnant is an important factor that can increase the risk of pregnancy complications after conception. There is growing evidence that using assisted reproductive methods to get pregnant also increases the risk of complications during pregnancy. The number of fertility issues affecting a woman can also have an impact on pregnancy complications and outcomes. The risks associated with each fertility issue and the effect it has on pregnancy complications and outcomes is unclear.
Methods & findings
This research reviewed a number of studies to assess the influence of different fertility issues on complications and pregnancy outcomes.
Assisted reproductive methods have led to women experiencing pregnancy later in life. Multiple studies have determined that advanced maternal age can have a negative effect on pregnancy outcomes. For example, a recent study noted that women over 40 had increased risks of preterm birth (delivering before the due date), low birth weight babies, and gestational diabetes. Other studies noted that women over 50 had 6.86 times the risk of placenta previa (when the placenta covers the cervix), while women over 45 had 5.8 times the risk of pregnancy-induced high blood pressure.
Obesity during pregnancy has been associated with a number of negative outcomes, including large for gestational age infants, stillbirth, gestational diabetes, and preeclampsia (a pregnancy disorder leading to high blood pressure and kidney damage). Studies have noted that the risk of preterm birth increased from 2- to 3-fold with increasing maternal body weight.
Endometriosis (growth of uterine tissue outside the uterus) has been associated with poor pregnancy outcomes. One study noted a 20% increase in the risk of pregnancy loss, and a 90% increase in the risk of ectopic pregnancy (when the embryo implants in the fallopian tube). Another study noted a slight increase in the risk of pregnancy loss in women with endometriosis who underwent assisted reproductive techniques.
The effect of fertility problems such as polycystic ovary syndrome (a syndrome in which hormones are unbalanced) on pregnancy outcomes was unclear. The effect of abnormal tissue in the uterus (such as fibroids, adenomyosis, and endometrial polyps) on pregnancy is also unclear.
The bottom line
The study concluded that there was a relationship between infertility problems and pregnancy complications and outcomes.
The fine print
There was limited high-quality data, and knowledge gaps remain.
Published By :
Reproductive BioMedicine Online
Aug 20, 2016