Pregnancy outcomes in women with inflammatory bowel disease who successfully conceived via assisted reproduction technique

Abstract

Objective

Women with inflammatory bowel disease (IBD) have an increased risk for adverse pregnancy outcome, so as women using assisted reproduction technology (ART). However, data are scarce regarding the risk imposed by the combination of both. Thus, we aimed to assess pregnancy outcome in these women.

Methods

A retrospective case–control study, of women with IBD who conceived using ART due to female infertility. The study group (IBD-ART) was matched using propensity score and compared in a 1:1 ratio with three control groups, IBD patients who conceived spontaneously (IBD-SP), women using ART (H-ART) and women who conceived spontaneously (H-SP).

Results

The study group comprised of 49 women with IBD conceived via ART that gave birth at our center during the study period. All studied groups did not differ in demographics and obstetric characteristics. IBD groups (both ART and spontaneous) were comparable in disease status prior and throughout pregnancy. Maternal outcome showed no difference regarding preterm birth and pregnancy complications among all studied groups. Women in the IBD-ART group had decreased rates of vaginal delivery (34.7% vs 57.1%, p = 0.032) and higher rates of elective CS (32.7% vs 14.3%, p = 0.048) in comparison to H-SP group, but comparable rates to both IBD-SP and H-ART groups. Neonatal outcomes were comparable among all studied groups. In a sub-analysis by disease type, a higher rate of gestational diabetes was found among ulcerative colitis patients using ART (29.4% Crohn's vs 6.1% UC, p = 0.025).

Conclusion

Patients with IBD undergoing ART have comparable pregnancy outcome to women using ART and to patients with IBD with spontaneous pregnancy.

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Funding

There was no grant support for this manuscript.

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Authors

Contributions

I.L. and M.L conceived and designed the study. I.L., M.L., R.D, participated in data acquisition. I.L. and Y.F performed data analysis and interpretation. I.L., M.L, Y.F, F.A and Y.Y participated in preparing the manuscript. All authors critically revised the manuscript for important intellectual property and approved submitting this manuscript.

Corresponding author

Correspondence to Michael Lavie.

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The authors declare full compliance with the ethical standards. We report no conflict of interest or funding.

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The institutional review board approved the study.

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Lavie, I., Lavie, M., Doyev, R. et al. Pregnancy outcomes in women with inflammatory bowel disease who successfully conceived via assisted reproduction technique. Arch Gynecol Obstet (2020). https://doi.org/10.1007/s00404-020-05644-w

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Keywords

  • Crohn's disease
  • Ulcerative colitis
  • Inflammatory bowel disease
  • Assisted reproduction technology
  • Fertility
  • Adverse birth outcomes