Perinatal outcomes of women with recurrent pregnancy loss undergoing frozen embryo transfer from the Society of Assisted Reproductive Technology database

Abstract

Objective: To assess whether infants born to women with a history of recurrent pregnancy loss (RPL) have an increased risk of adverse perinatal outcomes after frozen embryo transfer (FET) compared with women without a history of infertility or RPL. Design: Retrospective cohort study utilizing the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System database between 2014 and 2020. Subjects: Patients in the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System database who underwent their first FET resulting in live birth either with a diagnosis of RPL (cases n = 3,299) or without a history of RPL or infertility, the comparison population being tubal ligation (TL) only (n = 1,408). Exposure: Recurrent pregnancy loss. Main Outcome Measures: Low birthweight (<2,500 g), additional outcomes included gestational age (continuous), birthweight (continuous), preterm delivery (<37 weeks), mode of delivery, and neonatal death, defined as death before the completion of the 28th day of life. Results: We observed no statistically significant difference in low birthweight, birthweight overall, mode of delivery, or risk of neonatal death between patients with RPL compared with women with TL who underwent their first FET, resulting in live birth. Patients with history of RPL compared with TL utilizing FET were more likely to have a later gestational age at delivery. Patients with RPL were also less likely to have a preterm delivery (imputed adjusted odds ratio, 0.75; 0.64–0.89) than the patients with TL. Furthermore, performing preimplantation genetic testing for aneuploidy (PGT-A) in both patients with RPL or TL did not impact perinatal outcomes compared with patients who did not undergo PGT-A. Conclusion: Patients with history of recurrent pregnancy loss do not have an increased risk of adverse perinatal outcomes when they undergo FET compared with patients without infertility or RPL. In addition, performing in vitro fertilization/PGT-A in patients with RPL does not adversely impact birth outcomes of their infants.