Neonatal outcome following new assisted reproductive technology regulations in Turkey - a nationwide multicenter point prevalence study

J Matern Fetal Neonatal Med. 2015 Jan;28(2):204-9. doi: 10.3109/14767058.2014.908844. Epub 2014 Apr 24.

Abstract

Objective: In March 2010, a new legislation about assisted reproductive technology (ART) activities, favoring single embryo transfer, was introduced in Turkey. Consequences of new regulations on neonatal outcome have not been evaluated in multicenter studies yet. In this study, our aim was to evaluate neonatal outcome of infants from medically assisted reproduction (MAR) pregnancies in the post-legislation era.

Methods: A point prevalence study was conducted at 51 centers in Turkey on 1 April 2013. Data about fertility treatments and neonatal characteristics were evaluated for "live births" (Group 1) and "patients being cared in the NICU" (Group 2).

Results: Seventeen (4%) of 420 infants in group 1, and 89 (8.1%) of 1094 infants in group 2 were born after MAR pregnancies. The ratio of multiple births in MAR pregnancies was still very high as 47.1% for group 1, 69.1% for group 2 infants. MAR babies constituted 9.9% of infants in Level 3 NICUs and 7.6% infants in Level 2 NICUs. MAR was associated with increased risk of multiple births and prematurity.

Conclusions: After the new legislation, multiple birth rates are still high in MAR pregnancies, resulting in unfavorable neonatal outcomes. Efforts to decrease multiple birth rates should be encouraged.

Keywords: Assisted reproductive technology; legislation; medically assisted reproduction; morbidity; multiple births; newborn.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Birth Rate / trends
  • Cross-Sectional Studies
  • Female
  • Government Regulation
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Multiple Birth Offspring / legislation & jurisprudence
  • Multiple Birth Offspring / statistics & numerical data
  • Pregnancy
  • Pregnancy Outcome / epidemiology*
  • Pregnancy, Multiple / statistics & numerical data
  • Premature Birth / epidemiology
  • Prevalence
  • Reproductive Techniques, Assisted / legislation & jurisprudence*
  • Reproductive Techniques, Assisted / statistics & numerical data
  • Turkey / epidemiology