Obstetrics and Perinatal Outcomes in Assisted Reproductive Technology
Research type
Research Study
Full title
Obstetrics and Perinatal Outcomes in relation to various stages of assisted reproductive technology treatment
IRAS ID
265627
Contact name
Candice Cheung
Contact email
Sponsor organisation
Shrewsbury and Telford Hospital
Duration of Study in the UK
1 years, 2 months, 16 days
Research summary
This retrospective study is to evaluate whether the development of ovarian hyperstimulation syndrome (OHSS), the rate of development of embryos and the early embryonic development environment in relation to assisted reproductive technology treatment is associated with an increase in adverse perinatal outcomes. This will allow better counselling of affected patients and closer antenatal monitoring if results demonstrate a higher risk in this subgroup of patients.
Patients receive hormonal injections to maximise the number of eggs produced during treatment, this is termed ‘controlled ovarian stimulation’. However, some patients overrespond and develop OHSS and can become very poorly as fluid accumulates in the abdominal cavity and in severe cases in lung and heart spaces (pleural and pericardial effusion).
Traditionally, embryos are returned to the uterine cavity on day 3. In more recent years, studies have shown more promising outcomes when embryos are transferred on day 5 (blastocyst stage). Most embryos develop into blastocyst on day 5, but there are some slower developing embryos and only become blastocyst on day 6. We will compare the treatment and perinatal outcomes to evaluate whether slower developing embryos are associated with poorer outcomes.
Embryos are traditionally kept in incubators and evaluated daily for their development. The introduction of embryoscope allows minimal interruption of the early embryonic environment. We will compare the groups of patients who used embryoscope versus those who did not and evaluate if the group with embryoscope has a better treatment and perinatal outcome.
Retrospective data will be collected from the Mid Wales and Shropshire Fertility unit and Human Fertilisation and Embryology Authority, to evaluate the difference in biochemical pregnancy rates, clinical pregnancy rates, miscarriage rates, multiple pregnancy rates, birthweight, gestational age, congenital anomalies and other adverse neonatal outcomes. Secondary outcomes include development of pre-eclampsia, gestational hypertension and gestational diabetes.REC name
West Midlands - South Birmingham Research Ethics Committee
REC reference
19/WM/0347
Date of REC Opinion
28 Nov 2019
REC opinion
Favourable Opinion