Restriction lift date: 2021-08-20
Predicting successful outcome of singleton and multiple pregnancies after assisted reproductive technologies (ART)
University College Cork
Pregnancies conceived through ART are increasing in prevalence in maternity units in Ireland. This is due in a large part to the increasing age of women attempting to conceive for the first time but also due to the increasing success of ART. This thesis explores pre-pregnancy characteristics that may aid in predicting pregnancy outcome in women undergoing IVF treatment. The thesis includes three studies. The first is a retrospective study of the pregnancy outcomes of singleton and twin pregnancies conceived from ART. The study found that ART conceived twins had similar perinatal outcomes to spontaneously conceived twins. Overall, singleton pregnancy outcomes were very favourable. Singleton pregnancies, when compared to twin pregnancies, were more likely to result in a livebirth, while twin pregnancies were significantly more likely to result in miscarriage, preterm delivery and/or neonatal unit admission. The second study is a prospective cohort study of 142 nulliparous women at the outset of their IVF cycle. A 3D ultrasound of the uterine volume was performed. Women completed a survey on lifestyle and demographics. None of the interrogated demographics or lifestyle factors demonstrated a significant impact on conception nor on pregnancy loss. Neither uterine length nor volume impacted on pregnancy rates or on preterm delivery rates. The final study details the findings of a survey-based study of 320 women recruited prior to IVF treatment and followed for outcome (negative/positive pregnancy test, first trimester miscarriage). The survey focused on psychological stressors. The findings suggest that stressors do not impact greatly on conception rates from ART. Job-related stress is associated with higher chance of miscarriage. In the absence of any robust predictors of successful, or indeed adverse, pregnancy outcome it is preferable to aim for single embryo transfer and a singleton pregnancy.
IVF , Uterine volume , Stress and IVF , Stress and miscarriage , Assisted reproduction
Geisler, M. 2020. Predicting successful outcome of singleton and multiple pregnancies after assisted reproductive technologies (ART). MD Thesis, University College Cork.