Live birth is not the only relevant outcome in research assessing assisted reproductive technology

In assisted reproductive technology (ART) research, live birth has been generally accepted as an important outcome, if not the most important one. However, it has been reported inconsistently in the literature and solely focusing on live birth can lead to misinterpretation of research findings. In this review, we provide an overview on the definitions of live birth, including various denominators and numerators use. We present a series of real clinical examples in ART research to demonstrate the impact of variations in live birth on research findings and the importance of other outcomes, including multiple pregnancy, pregnancy loss, time to pregnancy leading to live birth, other short and long term maternal and offspring health outcomes and cost effectiveness measures. We suggest that outcome choices in ART research should be tailored for the research questions. A holistic outcome assessment beyond live birth would provide a full picture to Best Practice & Research Clinical Obstetrics and Gynaecology 86 (2023) 102306 address research questions in ART in terms of effectiveness and safety, and thus facilitate evidence-based decision making. (c) 2023 Elsevier Ltd. All rights reserved.

Automated summary

In assisted reproductive technology (ART) research, live birth is considered an important outcome but its interpretation can be misleading when solely focused on. This review presents an overview of the definitions of live birth and demonstrates through clinical examples the impact of variations in live birth on research findings, highlighting the importance of considering other outcomes such as multiple pregnancy, pregnancy loss, and maternal and offspring health outcomes. A holistic outcome assessment beyond live birth is necessary to inform evidence-based decision making in ART research.