Association between induced abortion history and later in vitro fertilization outcomes

Int J Gynaecol Obstet. 2018 Jun;141(3):321-326. doi: 10.1002/ijgo.12481. Epub 2018 Mar 27.

Abstract

Objective: To establish an effective and safe clinical fertility strategy by investigating the relationship between abortion history and pregnancy outcomes of in vitro fertilization (IVF) treatment.

Methods: In the present retrospective cohort study, data from IVF treatment cycles performed at a reproductive center in China between October 1, 2014, and October 31, 2015, were assessed. Outcomes were compared between women with a history of induced abortion and those without.

Results: There were 1532 IVF treatment cycles included; 454 patients had a history of induced abortion and 1078 did not. The spontaneous abortion rate was significantly higher (30/170 [17.6%] vs 41/420 [9.8%]; P=0.002) and the endometrium was significantly thinner (8.8 ± 1.8 vs 9.7 ± 1.8 cm; P=0.001) among patients with a history of induced abortion compared with those without. In a subgroup analysis of patients with a history of induced abortion, women who had undergone surgical abortions had a lower live delivery rate compared with medical abortions (29/76 [38%] vs 101/378 [27%]; P=0.039). Further, women who had a history of more than two surgical abortions had lower live delivery and clinical pregnancy rates (both P<0.05).

Conclusion: A history of induced abortion was associated with worse IVF outcomes, especially a history of more than two surgical abortions.

Keywords: Abortion; Clinical pregnancy rate; In vitro fertilization; Live birth rate; Spontaneous abortion rate.

MeSH terms

  • Abortion, Induced / statistics & numerical data*
  • Abortion, Spontaneous / epidemiology*
  • Adult
  • China
  • Cohort Studies
  • Endometrium / metabolism
  • Female
  • Fertility
  • Fertilization in Vitro / statistics & numerical data*
  • Humans
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Rate*
  • Retrospective Studies
  • Risk Factors