Corresponding author
Helena Ban Frangež, M.D., Ph.D.
Department of Human Reproduction, Division of Obstetrics and Gynecology,
University Medical Centre Ljubljana
Šlajmarjeva 3, 1000 Ljubljana, Slovenia
GSM: 386 41 336 441
helena.ban.frangez@gmail.com
Running title : Preterm delivery after reproductive surgery
Abstract
Objective: To evaluate an association between the mode of
conception and preterm delivery in women after reproductive surgery, and
to explore an effect of reproductive surgery on preterm delivery.
Design : Prospective cohort study and historical case-control
study.
Setting : Division of Obstetrics and Gynecology, Ljubljana,
Slovenia.
Population or sample : A cohort of 761 infertile women after
reproductive surgery.
Methods : In infertile women, we evaluated the association
between the mode of conception and preterm delivery using logistic
regression adjusted for relevant co-variables. In a case-control study
we evaluated the effect of reproductive surgery on preterm delivery
using propensity score method. We calculated the adjusted odds ratios
with a 95% confidence interval with a two-way test.
Main Outcome Measure : Preterm delivery.
Results : Among 761 infertile women, 428 (56.2%) conceived
spontaneously, and 333 (43.8%) conceived after IVF/ICSI. The incidence
of twin pregnancies was significantly lower after spontaneous conception
(2.6% vs. 14.1%; p <0.000 ). Adjusted logistic
regression analysis in singleton pregnancies disclosed no significant
association between the mode of conception and preterm delivery.
Compared with fertile women, the incidences of preterm deliveries
< 37, and < 32 gestational weeks were higher in
infertile women (11.2% vs. 14.2%, and 1.7% vs. 2.6%, respectively).
However, the differences did not reach a statistical significance
(p=0.076 and p=0.218 , respectively).
Conclusion: In selected infertile women after reproductive
surgery, a high rate of spontaneous conception, a low rate of multiple
pregnancies, and no treatment-related adverse effect on preterm delivery
should be the reasons to encourage spontaneous conception after
reproductive surgery.
Funding: The authors received no funding.
Keywords : reproductive surgery, preterm delivery, spontaneous
conception, IVF/ICSI, infertile women