Evaluation of Maternal and Neonatal Outcomes in Women Are Conceived Through Assisted Reproductive Technology Compared to Other Fertility Treatments and Naturally Conceived Women: It is a Retrospective Cohort Study Conducted Over a 5-year Period At a Fertility Center in a Lebanese Hospital

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Total Enrollment

1000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-09-01

Study Completion Date

2025-08-31

Brief Summary

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Background: The number of couples experiencing difficulties conceiving and seeking treatment for infertility has increased dramatically over time. Treatment options for infertility have evolved significantly over the past four decades, expanding to include assisted reproductive technologies (ART). However, the impact of ART on pregnancy outcomes remains unclear. Studies have shown that ART pregnancies are associated with a higher risk of maternal and neonatal adverse outcomes compared to those resulting from spontaneous conception. To this date, no comprehensive studies have been conducted in Lebanon to assess this association. Therefore, it is crucial to evaluate whether Lebanese women who conceive via ART are at higher risk for maternal and birth-related complications.

Objective: The aim of this study is to evaluate maternal and neonatal outcomes among women who conceived through assisted reproductive technology (ART), compared to those who conceived via other fertility treatments or naturally, at Dr. Ghazeeri's clinic at the American University of Beirut Medical Center.

Methods: Investigators propose to conduct an observational retrospective cohort study involving all pregnant women treated by Dr. Ghazeeri who delivered at the American University of Beirut Medical Center between 2018 and 2023. Pregnancies exposed to assisted reproductive technology (ART) or other fertility treatments will be matched to a group of spontaneous pregnancies based on propensity scores. The study has been initiated following approval from the Institutional Review Board (IRB) at the American University of Beirut Medical Center. Data analysis will be performed using SPSS version 26.

Expected Results: If no associations are found between ART or other fertility treatments and an increased risk of maternal and neonatal outcomes, the results will provide reassurance for mothers seeking these treatments. However, if associations are identified, policymakers will need to establish comprehensive regulations outlining the appropriate use of these technologies. Additionally, these findings would lay the groundwork for obstetricians to implement closer monitoring and more careful management during pregnancy.

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Detailed Description

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i. Study Design Investigators propose to conduct an observational retrospective cohort study on all pregnant women who delivered at Dr. Gahzeeri's clinic at the American University of Beirut Medical Center between 2018 and 2023. Investigators have obtained approval from the Institutional Review Board (IRB) at AUB, which is valid until August 2025.

ii. Sample Size: As this is a retrospective cohort study, the sample size will be determined by the number of participants who meet the inclusion criteria.

iii. Population The patient characteristics will be extracted from the Epic electronic health record system at the hospital. Pregnancies exposed to ART or other fertility treatments will be matched to spontaneous pregnancies based on propensity scores

In this study, the subjects will be divided into two groups:

1. Exposed group:

* Group One (ART group): pregnancies conceived via either IVF/ICSI and/or Assisted hatching (AH) and/or Pre-implantation genetic testing (PGT).
* Group one will also be subdivided into fresh embryo transfer (ET) and frozen embryo transfer (FET) subgroups based on the type of embryo transfer method used.
* Group Two (Non-ART group): pregnancies conceived through ovulation induction (OI) and/or intrauterine insemination (IUI) and/or corrective gynecological surgery.
2. Non-exposed group: spontaneous pregnancies, defined as pregnancies resulting from natural conception.

Conditions

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Preterm Birth Gestational Diabetes Mellitus (GDM) Gestational Hypertension

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Exposed Group

The exposed group is subdivided into:

Group one (Assisted Reproductive Technology group): pregnancies conceived via either in-vitro fertilization (IVF) with or without intracytoplasmic sperm injection (ICSI) with or without assisted hatching (AH) with or without pre-implantation genetic testing (PGT).

Group two (Non-Assisted Reproductive Technology Group): pregnancies conceived through ovulation induction (OI) and/or intrauterine insemination (IUI) and/or corrective gynecological surgery.

Since this is an observational study rather than an interventional study, the exposure type refers to all potential factors influencing pregnancy both before and during pregnancy

Intervention Type OTHER

Since this is an observational study rather than an interventional study or clinical trial, the exposure type refers to all potential factors influencing pregnancy both before conception and during pregnancy. These exposures include:

Lifestyle habits: Such as obesity, smoking and alcohol use before and during pregnancy.

Sociodemographic factors: Such as age, residence, medical insurance. Medications: Any prescription, over-the-counter, or herbal medications used before or during pregnancy.

Past medical history: Pre-existing medical conditions or illnesses, such as hypertension, diabetes, or autoimmune diseases, that could affect pregnancy.

Past surgical history: Previous surgeries, especially those related to the reproductive system or any that may impact pregnancy outcomes.

Previous pregnancies: Information about past pregnancies, including the number of full-term and preterm births, complications, and outcomes.

Abortions: Any history of miscarriages

Non-exposed Group

Spontaneous pregnancies, defined as pregnancies resulting from natural conception.

Since this is an observational study rather than an interventional study, the exposure type refers to all potential factors influencing pregnancy both before and during pregnancy

Intervention Type OTHER

Since this is an observational study rather than an interventional study or clinical trial, the exposure type refers to all potential factors influencing pregnancy both before conception and during pregnancy. These exposures include:

Lifestyle habits: Such as obesity, smoking and alcohol use before and during pregnancy.

Sociodemographic factors: Such as age, residence, medical insurance. Medications: Any prescription, over-the-counter, or herbal medications used before or during pregnancy.

Past medical history: Pre-existing medical conditions or illnesses, such as hypertension, diabetes, or autoimmune diseases, that could affect pregnancy.

Past surgical history: Previous surgeries, especially those related to the reproductive system or any that may impact pregnancy outcomes.

Previous pregnancies: Information about past pregnancies, including the number of full-term and preterm births, complications, and outcomes.

Abortions: Any history of miscarriages

Interventions

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Since this is an observational study rather than an interventional study, the exposure type refers to all potential factors influencing pregnancy both before and during pregnancy

Since this is an observational study rather than an interventional study or clinical trial, the exposure type refers to all potential factors influencing pregnancy both before conception and during pregnancy. These exposures include:

Lifestyle habits: Such as obesity, smoking and alcohol use before and during pregnancy.

Sociodemographic factors: Such as age, residence, medical insurance. Medications: Any prescription, over-the-counter, or herbal medications used before or during pregnancy.

Past medical history: Pre-existing medical conditions or illnesses, such as hypertension, diabetes, or autoimmune diseases, that could affect pregnancy.

Past surgical history: Previous surgeries, especially those related to the reproductive system or any that may impact pregnancy outcomes.

Previous pregnancies: Information about past pregnancies, including the number of full-term and preterm births, complications, and outcomes.

Abortions: Any history of miscarriages

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* All pregnant ladies of Lebanese Nationality only who delivered at the American University of Beirut Medical Center (AUB-MC) between Nov 2018- Nov 2023
* Pregnancies that were delivered at least 20 weeks of gestation (≥ 20 weeks)
* All pregnant women who are in procreation age (20-50 years old)
* For pregnant women by ART: only if ART is done at the AUB-MC
* Subject's file being accessible for all the three trimesters
* Subjects being followed up until delivery only at the AUB-MC
* Subjects whom their baby or babies' records are available (it could be multiples)

Exclusion Criteria

* Subjects who started their follow-up after the 1st trimester (missing data before 12 weeks).
* All subjects with history of severe chronic conditions before gestation such as, pre-existing cancer, heart diseases (coronary artery disease, arrhythmia, cardiac defects, ischemic stroke, venous thromboembolism, liver disease and/or kidney disease, history of nervous system disorders (seizures, depression).
* Subjects who undergone ART elsewhere
* Subjects who lost to follow up during their pregnancies (missing data)
* Moms who delivered outside the AUBMC hospital

Minimum Eligible Age

20 Years

Maximum Eligible Age

50 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes