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Complications of assisted reproductive technology treatment and the factors influencing reproductive outcome
Author(s) -
Bhandari Harish M,
Choudhary Meenakshi K,
Stewart Jane A
Publication year - 2018
Publication title -
the obstetrician and gynaecologist
Language(s) - English
Resource type - Journals
eISSN - 1744-4667
pISSN - 1467-2561
DOI - 10.1111/tog.12504
Subject(s) - assisted reproductive technology , medicine , pregnancy , psychological intervention , fertility , ovarian hyperstimulation syndrome , reproductive technology , infertility , gynecology , intensive care medicine , obstetrics , population , in vitro fertilisation , environmental health , psychiatry , genetics , lactation , biology
Key content Ovarian hyperstimulation syndrome and multiple pregnancy risks are the two key complications of assisted reproductive technology (ART) treatment. There appears to be no direct association between ART treatment and an increased risk of invasive cancer in infertile women, but there may be a small increased risk of borderline ovarian tumours. There is suggestive, yet unconvincing, evidence that ART treatment may increase several risks, including childhood cancer risk to children. A slight increase in the risk of some adverse perinatal outcomes following ART treatment may be caused by the underlying fertility problem. Female age, ovarian reserve markers and previous obstetric history are the best predictors of ART success. Currently, there is insufficient evidence to recommend the routine use of some of the interventions to improve reproductive outcome.Learning objectives To have an overview of different iatrogenic complications for women undergoing ART and the child or children born following ART treatment. To understand the evidence‐based synopsis of factors affecting ART success. To appreciate the limited or conflicting nature of available evidence for certain interventions used to maximise ART treatment outcome.Ethical issues Should ART treatment be offered to older women? What are the long‐term safety implications of some of the ‘adjuvants’ used to improve ART success?