Examination of fetal growth trajectories following infertility treatment.

PURPOSE: The objective of this retrospective cohort study was to compare fetal growth during the second and third trimesters for ovulation induction with intrauterine insemination (IUI), fresh embryo transfer (ET), frozen embryo transfer (FET), and spontaneous conception following infertility. METHODS: Three hundred ninety-five women with viable pregnancies confirmed at a single academic fertility center participated. All women achieved pregnancy either by treatment or spontaneously after a diagnosis of infertility. Inclusion criteria included autologous singleton pregnancies. Exclusion criteria included pregnancies from donor oocytes, twins, unavailable ultrasound data, and treatment methods with small number of participants. Primary outcomes of interest were head circumference (HC), abdominal circumference (AC), HC/AC ratio, and estimated fetal weight (EFW). Conditional growth curve models were created, and growth curves were selected for each outcome of interest. RESULTS: For ovulation induction with IUI, fresh ET, FET, and spontaneous conception, the slope analysis of growth curves for per-week growth rate of HC, AC, HC/AC ratio, and EFW demonstrated no difference. A subgroup analysis of fresh ET and FET groups, for same outcomes, also showed no difference. CONCLUSION: These findings contribute to the very limited literature on fetal growth trajectories following infertility treatment and suggest no significant differences in fetal growth for ovulation induction with IUI, fresh ET, FET, and spontaneous conception following infertility. It is possible there were no differences in growth trajectories between these conception methods because the majority of children born following infertility are of normal birth weight. While results are reassuring, further research with larger populations is warranted.

Blastocyst formation rate for Asians versus Caucasians and within body mass index categories.

PURPOSE: There are well-documented racial and ethnic disparities for in vitro fertilization (IVF) outcomes, including disparities in clinical pregnancy and live birth rate. Obesity has also been associated with an increase in the risk of infertility and reduction in the efficacy of fertility treatment. However, there are limited data regarding the potential effect of race and obesity on in vitro embryo development. The purpose of this study was to determine whether blastocyst formation rates vary with race and body mass index (BMI). METHODS: This retrospective analysis included 1134 fresh autologous cycles (N = 8266 embryos), which took place from January 2013 to December 2016. Women were categorized as Caucasian, Asian (not Indian), and Indian (South Asian) and by BMI categories (normal, overweight, and obese). Regression analyses were performed using race and BMI as the primary predictor variables and blastocyst formation as the outcome. RESULTS: Compared to Caucasian, the adjusted OR for blastocyst development was 0.85 (95% CI 0.72-1.00) for Asian women and 1.15 (95% CI 0.95-1.38) for Indian women. Women who were overweight (aOR 0.93; 95% CI 0.77-1.12) or obese (aOR 0.92; 95% CI 0.74-1.12) had similar odds of blastocyst formation comparing to women with normal BMI. Furthermore, analyses examining combined effects of race and BMI revealed no differences in blastocyst formation among Asian or Indian women with varied BMI categories compared to Caucasian women with normal BMI. CONCLUSION: Blastocyst formation did not differ based on race or BMI.

In vitro fertilization outcomes after fresh and frozen blastocyst transfer in South Asian compared with Caucasian women.

OBJECTIVE: To study pregnancy outcomes between South Asian and Caucasian women undergoing frozen blastocyst transfer cycles. DESIGN: Retrospective cohort study. SETTING: Not applicable. PATIENT(S): Caucasian and South Asian patients undergoing frozen blastocyst transfer between January 2011 and December 2014. INTERVENTION(S): Not applicable. MAIN OUTCOME MEASURE(S): Live birth rate. RESULT(S): A total of 196 Caucasian and 117 South Asian women were included in our study. Indians were on average 2.2 years younger than Caucasian women (34.9 vs. 37.1 years), and were more likely to be nulliparous (59% vs. 43%). All other baseline characteristics were similar. In women undergoing their first frozen ET cycle, implantation rate (49% vs. 47%), clinical pregnancy rate (PR; 54% vs. 49%), and live birth rate (43% vs. 43%) were similar between South Asians and Caucasians, respectively. In patients who underwent a prior fresh blastocyst transfer, the live birth rate was significantly lower in South Asian versus Caucasian women (21% vs. 37%). CONCLUSION(S): Our data demonstrate that IVF outcomes are better in frozen versus fresh cycles among South Asian women. The IVF clinics may wish to consider these findings when counseling South Asian patients about the timing of ET.