Impact of recurrent pregnancy loss history on reproductive outcomes in women undergoing fertility treatment

Jiaxin Qiu, Tong Du, Wentao Li, Ming Zhao, Dong Zhao* (Corresponding Author), Yun Wang* (Corresponding Author), Yanping Kuang* (Corresponding Author), Ben W. Mol

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Background: Recurrent pregnancy loss negatively affects the reproductive outcomes of natural conception. Preimplantation genetic testing for aneuploidies has been the focus of interventions in women with recurrent pregnancy loss. However, the risk of no embryos being available, high costs, and uncertainties surrounding its effectiveness limit its use. Factors beyond euploidy, such as an appropriate intrauterine environment, are also important for improving the reproductive outcomes in women with recurrent pregnancy loss. It remains unknown whether a history of recurrent pregnancy loss can affect reproductive outcomes after fertility treatment. Objective: This study aimed to investigate the impact of history of recurrent pregnancy loss on the reproductive outcomes of women undergoing fertility treatment. Study Design: This was a retrospective cohort study of women who underwent their first frozen embryo transfer cycle or intrauterine insemination cycle between January 2014 and July 2020 in Shanghai, China. We excluded couples with known karyotypic abnormalities (eg, balanced translocation) or uterine malformation. We performed multivariate binary logistic regressions for biochemical pregnancy, miscarriage, and live birth rates to investigate the associations between recurrent pregnancy loss history and reproductive outcomes. Results: A total of 29,825 women who underwent frozen embryo transfer cycles and 5476 women who underwent intrauterine insemination cycles were included in this study. In those who underwent frozen embryo transfer, history of recurrent pregnancy loss was not significantly associated with biochemical pregnancy (adjusted odds ratio, 1.19; 95% confidence interval, 0.87–1.63), miscarriage (adjusted odds ratio, 0.99; 95% confidence interval, 0.78–1.26), or live birth rates (adjusted odds ratio, 0.91; 95% confidence interval, 0.79–1.06). Similarly, in frozen embryo transfer cycles that led to clinical pregnancy, recurrent pregnancy loss history was not significantly associated with live birth (adjusted odds ratio, 0.99; 95% confidence interval, 0.76–1.28) or miscarriage rates (adjusted odds ratio, 1.04; 95% confidence interval, 0.81–1.35). In women with intrauterine insemination, history of recurrent pregnancy loss showed no significant associations with fertility outcomes in all cycles ([adjusted odds ratio, 1.36; 95% confidence interval, 0.88–2.10] for live birth rate and [adjusted odds ratio, 1.74; 95% confidence interval, 0.75–4.01], for miscarriage rate) and in cycles that led to clinical pregnancy ([adjusted odds ratio, 0.70; 95% confidence interval, 0.31–1.63] for live birth rate and [adjusted odds ratio, 1.45; 95% confidence interval, 0.58–3.63] for miscarriage rate). Conclusion: In women without obvious chromosome abnormality and uterine malformation who undergo fertility treatment, recurrent pregnancy loss history was not significantly associated with miscarriage and live birth rates, suggesting that it has little or no prognostic value in predicting the reproductive outcomes of frozen embryo transfer or intrauterine insemination cycles.

Original languageEnglish
Pages (from-to)66.e1-66.e9
Number of pages9
JournalAmerican Journal of Obstetrics and Gynecology
Volume228
Issue number1
Early online date22 Dec 2022
DOIs
Publication statusPublished - Jan 2023

Bibliographical note

Funding Information:
B.W.M. reports consultancy for ObsEva and research funding from Ferring and Merck. W.L. reports grants from the Norman Beischer Medical Research Foundation outside the work of this study. Other authors declare no competing interests related to the study.

This work was supported by the National Ministry of Technology (grant number 2018YFC1003000 ), the Elite Team Project of Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine (grant number JY201801 ), Shanghai Sailing Program (grant number 21YF1423200 ), the Fundamental Research Program of the Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine (grant number JYZZ117 ), and National Natural Science Foundation of China (grant numbers 82201912 , 31770989 and 82071615). B.W.M. is supported by a National Health and Medical Research Council Investigator grant (grant number 1176437 ). The funding sources had no involvement in the design, conduct, analysis, and reporting of the study.

Publisher Copyright:
© 2022 Elsevier Inc.

Keywords

  • fertility outcomes
  • frozen embryo transfer
  • in vitro fertilization
  • intracytoplasmic sperm injection
  • intrauterine insemination
  • miscarriage risk
  • recurrent pregnancy loss

Fingerprint

Dive into the research topics of 'Impact of recurrent pregnancy loss history on reproductive outcomes in women undergoing fertility treatment'. Together they form a unique fingerprint.

Cite this