Maternal characteristics and pregnancy outcomes after assisted reproductive technology by infertility diagnosis: ovulatory dysfunction versus tubal obstruction

Objective: To examine differences in maternal characteristics and pregnancy outcomes between women with ovulatory dysfunction (OD) and women with tubal obstruction (TO) who underwent assisted reproductive technology (ART). Design: Retrospective cohort study. Setting: Centers for Disease Control and Prevention. Patient(s): Exposed and nonexposed groups were selected from the 2000-2006 National ART Surveillance System linked with livebirth certificates from three states: Florida, Massachusetts, and Michigan. Intervention(s): None. Main Outcome Measure(s): Maternal characteristics and pregnancy outcomes, including newborn's health status right after delivery (Apgar score,< 7 vs. >= 7) as the study outcome of interest, were assessed among women with OD/polycystic ovary syndrome (PCOS) and TO who used ART. Result(s): A significantly higher prevalence of women with OD/PCOS were younger (< 35 years of age; 65.7% vs. 48.9%), were white (85.4% vs. 74.4%), had higher education (29.4% vs. 15.6%), and experienced diabetes (8.8% vs. 5.3%) compared with those having TO. The odds of having a lower (< 7) Apgar score at 5 minutes were almost twice as high among newborns of women with OD/PCOS compared with those with TO (crude odds ratio, 1.86; 95% confidence interval [CI], 1.31, 2.64; adjusted odds ratio, 1.90; 95% CI, 1.30, 2.77). Conclusion(s): Women with OD/PCOS who underwent ART have different characteristics and health issues (higher prevalence of diabetes) and infant outcomes (lower Apgar score) compared with women with TO. (C)2014 by American Society for Reproductive Medicine.)