Placental pathology of term singleton live births conceived with fresh embryo transfer compared with those conceived without assisted reproductive technology

Objective: To compare placental pathology from term singleton live births conceived with fresh embryo transfer vs. those conceived without assisted reproductive technology (ART). Design: Retrospective cohort study. Setting: Academic fertility center. Patient(s): Women with a term singleton live birth who conceived after fresh autologous in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles (ART group) and those who conceived without ART. Intervention(s): An experienced placental pathologist categorized placental pathology as anatomic, inflammatory, or vascular. Patient characteristics were compared by chi-squared tests, Student's t-test, or nonparametric tests. Multivariate logistic regression models were used to compare placental pathology between pregnancies conceived with and without ART. Main Outcome Measure(s): Incidence of anatomic, inflammatory, and vascular placental pathology. Result(s): There was a higher incidence of placental pathology in the ART group (n = 511) than in the non-ART group (n = 121), specifically anatomic (adjusted odds ratio [aOR] 2.50, 95% confidence interval [CI] 1.42-4.40) and vascular (aOR 2.00, 95% CI 1.133.53) pathology. These findings were driven primarily by the significantly higher odds of anatomic (aOR 2.97, 95% CI 1.55-5.66) and vascular (aOR 1.98, 95% CI 1.04-3.75) pathology observed in ICSI pregnancies. Single blastocyst transfers remained associated with increased anatomic pathology (ART: aOR 4.89, 95% CI 2.28-10.49; ICSI: aOR 3.38, 95% CI 1.49-7.71). Conclusion(s): Fresh embryo transfer is associated with increased anatomic and vascular placental pathology in term singleton live births compared with conception without ART. This finding should be investigated prospectively in a larger cohort of patients. (C) 2021 by American Society for Reproductive Medicine.) El resumen esta disponible en Espanol al final del articulo.

Automated summary

This study compared placental pathology between term singleton live births conceived with fresh embryo transfer and those conceived without assisted reproductive technology (ART). The study found a higher incidence of placental pathology in the ART group, particularly anatomic and vascular pathology. Additionally, significantly increased anatomic and vascular pathology were observed in ICSI pregnancies. Prospective studies with larger cohorts of patients are needed to further investigate these findings.