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IBD linked to lower success rates with assisted reproductive technology treatments
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Women with ulcerative colitis and Crohn’s disease have lower success rates per embryo transfer when undergoing assisted reproductive technology treatments compared with women who do not have inflammatory bowel disease, according to data published in Gut.
“Women with CD may seek to initiate [assisted reproductive technology] treatment before needing CD surgery. Increased prenatal observation in UC pregnancies after ART should be considered,” Sonia Friedman, MD, of Odense University Hospital in Denmark, the Crohn’s and Colitis Center at Brigham and Women’s Hospital and Harvard Medical School in Boston, and colleagues wrote.
Sonia Friedman
Using Danish health registries, the researchers identified a nationwide cohort of all women with an embryo transfer between Jan. 1, 1994 and Jan. 1, 2013, and evaluated for differences in the chance of live births and adverse birth outcomes in women with UC and CD compared with women who did not have IBD.
The cohort consisted of 432 women with UC who underwent 1,360 ART treatments; 182 women with CD who underwent 554 ART treatments; and 52,489 women without IBD who underwent 148,540 ART treatments.
The primary outcome was live births per ART treatment, and the secondary outcome was adverse outcomes per ART treatment.
Compared with women without IBD, the chances of having a live birth for each embryo transfer in women receiving ART treatment was significantly reduced in women with UC (OR = 0.73; 95% CI, 0.58-0.92). The chances were reduced in women with CD, but the reduction was not statistically significant in the full model (OR = 0.77; 95% CI, 0.52-1.14). However, the chances of having a live birth for each embryo transfer were significantly reduced in women who underwent surgery for CD prior to ART treatment (OR = 0.51; 95% CI, 0.29-0.91).
The risk for preterm birth was significantly increased for women with UC (OR = 5.29; 95% CI, 2.41-11.63); however, no increased risk for adverse birth outcomes was observed in the women with CD.
“We conclude that women with UC and CD have a reduced chance of a live birth per ART treatment cycle compared with women without IBD,” the researchers wrote. “In addition, women with CD, but not women with UC, with prior surgery have a decreased chance of a live birth per cycle. These findings might be related to the disease itself or to factors closely related to UC and CD, and additional studies are needed in this area. Our results further suggest that increased prenatal observation in UC pregnancies after infertility treatment should be recommended.” – by Suzanne Reist
Disclosures: The researchers report no relevant financial disclosures.
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