Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar;117(3):593-602.
doi: 10.1016/j.fertnstert.2021.11.012. Epub 2022 Jan 17.

Hospitalizations up to 8 years following delivery in assisted reproductive technology-treated and subfertile women

Leslie V Farland  1 , Chia-Ling Liu  2 , Hafsatou Diop  2 , Howard J Cabral  3 , Stacey A Missmer  4 , Charles C Coddington  5 , Sunah S Hwang  6 , Judy E Stern  7
Affiliations

Hospitalizations up to 8 years following delivery in assisted reproductive technology-treated and subfertile women

Leslie V Farland et al. Fertil Steril. 2022 Mar.

Abstract

Objective: To investigate hospitalizations up to 8 years after live birth among women who used assisted reproductive technology (ART) or who were subfertile compared with women who conceived naturally.

Design: Retrospective cohort.

Setting: Deliveries among privately insured women aged ≥18 years between 2004 and 2017 from Massachusetts state vital records were linked to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System and hospital observational/inpatient stays.

Patient(s): We compared patients with ART, medically assisted reproduction (MAR), and unassisted subfertile (USF) delivery with those with fertile delivery.

Intervention(s): NA.

Main outcome measure(s): Postdelivery hospitalization information was derived from the International Classification of Diseases codes for discharges and combined by type. The relative risks and 95% confidence intervals (CIs) of hospitalization for up to the first 8 years postdelivery were modeled.

Result(s): Among 492,515 deliveries, 5.6% used ART, 1.6% used MAR, and 1.8% were USF. Compared with fertile deliveries, deliveries that used ART or MAR or were USF were more likely to have hospital utilization (inpatient or observational stay) for any reason for up to 8 years of follow-up (USF, adjusted relative risk [aRR], 1.18 [95% CI, 1.12-1.25]; MAR, aRR, 1.20 [1.13-1.27]; and ART, aRR, 1.29 [1.25-1.34]). Assisted reproductive technology deliveries had an increased risk of hospitalization for conditions of the cardiovascular system (aRR, 1.31 [95% CI, 1.20-1.41]), overweight/obesity (aRR, 1.30 [1.17-1.44]), diabetes (aRR, 1.25 [1.05-1.49]), reproductive tract (aRR, 1.62 [1.47-1.79]), digestive tract (aRR, 1.39 [1.30-1.49]), thyroid (aRR, 2.02 [1.80-2.26]), respiratory system (aRR, 1.13 [1.03-1.24]), and cancer (aRR, 1.40 [1.18-1.65]) up to 8 years after delivery. Deliveries with MAR and subfertility had similar patterns of hospitalization as ART deliveries.

Conclusion(s): Women who conceived through fertility treatment or experienced subfertility were at increased risk of subsequent hospitalization resulting from a variety of chronic and acute conditions.

Keywords: ART; cancer; cardiovascular disease; infertility; subfertility.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Chandra A, Copen CE, Stephen EH. Infertility service use in the United States: data from the National Survey of Family Growth, 1982–2010. Natl Health Stat Report 2014:1–21. - PubMed
    1. Thoma ME, McLain AC, Louis JF, King RB, Trumble AC, Sundaram R et al. Prevalence of infertility in the United States as estimated by the current duration approach and a traditional constructed approach. Fertil Steril 2013;99:1324–31 e1. - PMC - PubMed
    1. Toner JP, Coddington CC, Doody K, Van Voorhis B, Seifer DB, Ball GD et al. Society for Assisted Reproductive Technology and assisted reproductive technology in the United States: a 2016 update. Fertil Steril 2016;106:541–6. - PubMed
    1. Luke B, Stern JE, Kotelchuck M, Declercq ER, Cohen B, Diop H. Birth Outcomes by Infertility Diagnosis Analyses of the Massachusetts Outcomes Study of Assisted Reproductive Technologies (MOSART). J Reprod Med 2015;60:480–90. - PMC - PubMed
    1. Stern JE, Liu CL, Cabral HJ, Richards EG, Coddington CC, Hwang S et al. Birth outcomes of singleton vaginal deliveries to ART-treated, subfertile, and fertile primiparous women. Journal of assisted reproduction and genetics 2018;35:1585–93. - PMC - PubMed

Publication types