Birthweight in infants conceived through in vitro fertilization following blastocyst or cleavage-stage embryo transfer: a national registry study

  • Julia F. Litzky
  • Sheree L. Boulet
  • Navid Esfandiari
  • Yujia Zhang
  • Dmitry M. Kissin
  • Regan N. Theiler
  • Carmen J. Marsit
Assisted Reproduction Technologies
  • 33 Downloads

Abstract

Purpose

In vitro fertilization (IVF) infants have lower birthweights than their peers, predisposing them to long-term health consequences. Blastocyst transfer (BT), at day 5–6 post-fertilization, is increasing in usage, partially due to improved pregnancy outcomes over cleavage-stage transfer (CT, day 2–3). Data to date, however, have been inconclusive regarding BT’s effects on birthweight.

Methods

Participants included all US autologous, single-gestation, fresh embryo transfer cycles initiated from 2007 to 2014 that resulted in a term infant (N = 124,154) from the National Assisted Reproductive Technology Surveillance System. Generalized linear models including obstetric history, maternal demographics, and infant sex and gestational age were used to compare birthweight outcomes for infants born following BT (N = 67,169) with infants born following CT (N = 56,985) and to test for an interaction between transfer stage and single embryo transfer (SET).

Results

Infants born following BT were 6 g larger than those born following CT (p = 0.04), but rates of macrosomia (RR 1.00, 95% CI 0.96–1.04) and low birthweight (LBW, RR 1.00, 95% CI 0.93–1.06) were not different between the groups. The interaction between SET and transfer stage was significant (p = 0.02). Among SET infants, BT was associated with 19.26 g increased birthweight compared to CT (p = 0.008).

Conclusions

The increase in birthweights identified following BT is unlikely to be clinically relevant, as there were no differences in rates of macrosomia or LBW. These findings are clinically reassuring and indicate that the increasing use of BT is unlikely to further decrease the on average lower birthweights seen in IVF infants compared to their naturally conceived peers.

Keywords

Birthweight In vitro fertilization Embryo transfer Blastocyst Cleavage-stage embryo 

Notes

Compliance with ethical standards

This project was approved by the Institutional Review Board at the CDC.

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

10815_2018_1168_MOESM1_ESM.pdf (88 kb)
Supplemental Table 1 (PDF 88kb)
10815_2018_1168_MOESM2_ESM.pdf (88 kb)
Supplemental Table 2 (PDF 87kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Julia F. Litzky
    • 1
  • Sheree L. Boulet
    • 2
  • Navid Esfandiari
    • 3
    • 4
  • Yujia Zhang
    • 2
  • Dmitry M. Kissin
    • 2
  • Regan N. Theiler
    • 5
  • Carmen J. Marsit
    • 6
  1. 1.Department of EpidemiologyGeisel School of Medicine at Dartmouth CollegeHanoverUSA
  2. 2.Division of Reproductive HealthNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaUSA
  3. 3.Department of Obstetrics and GynecologyGeisel School of Medicine at Dartmouth CollegeHanoverUSA
  4. 4.Department of Pathology and Laboratory MedicineGeisel School of Medicine at Dartmouth CollegeHanoverUSA
  5. 5.Department of Obstetrics and GynecologyMayo ClinicRochesterUSA
  6. 6.Department of Environmental Health, Rollins School of Public HealthEmory UniversityAtlantaUSA

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