In Vitro Fertilization is Associated with an Increased Risk for Preeclampsia

Objective: To assess the association of intrauterine insemination, in vitro fertilization (IVF) and ovulation induction with the risk of preeclampsia. Methods: We conducted a population based retrospective cohort study of pregnancies conceived by assisted reproductive technology (1357 exposure subjects, 5190 controls) based on 2005 Niday Perinatal Database for Ontario, Canada. All pregnancies conceived by assisted reproductive technology were identified as exposure group. Four controls were randomly matched for each exposure subject by maternal age, parity, plurality, and delivery hospital level and residence area. The risks for preeclampsia associated with intrauterine insemination, IVF, and ovulation induction were evaluated through conditional logistic regression models compared with their corresponding controls. Results: With adjustment of maternal age, smoking during pregnancy and initiating time of prenatal care, in vitro fertilization was associated with an increased risk for preeclampsia (OR = 1.78, 95% CI: 1.05, 3.06), whereas intrauterine insemination (OR = 2.44, 95% CI: 0.74, 8.06) and ovulation induction (OR = 1.34, 95% CI: 0.31, 5.75) was not associated with the risk for preeclampsia. Conclusion: There was a higher incidence of preeclampsia among pregnancies conceived by IVF, but no significant association was found in intrauterine insemination and ovulation induction.