The following is a summary of “Impact of recurrent pregnancy loss history on reproductive outcomes in women undergoing fertility treatment,” published in the January 2023 issue of Obstetrics and Gynecology by Qiu, et al.

The results of spontaneous conception are significantly impacted by recurrent pregnancy loss. Interventions for women who have repeated pregnancy losses have centered on preimplantation genetic testing for aneuploidies. However, its application was constrained by the possibility of running out of embryos, expensive expenses, and questions about its efficacy. For improving the reproductive outcomes in women who experience recurrent pregnancy loss, factors other than euploidy, such as a favorable intrauterine environment, were also crucial. It was uncertain if a history of repeated miscarriages might alter the results of fertility treatment in terms of reproduction. For a study, researchers sought to examine the effects of a history of repeated miscarriages on the reproductive outcomes of women receiving fertility therapy.

Women who performed their first round of intrauterine insemination or frozen embryo transfer between January 2014 and July 2020 in Shanghai, China were included in the retrospective cohort analysis. Couples with uterine malformations or known karyotypic abnormalities (such as balanced translocation) were excluded. To examine the relationships between a history of recurrent pregnancy loss and reproductive outcomes, they ran multivariate binary logistic regressions for biochemical pregnancy, miscarriage, and live birth rates.

The research comprised a total of 29,825 women who had frozen embryo transfer cycles and 5,476 women who completed cycles of intrauterine insemination. History of recurrent pregnancy loss was not significantly related to biochemical pregnancy (adjusted odds ratio, 1.19; 95% CI, 0.87-1.63), miscarriage (adjusted odds ratio, 0.99; 95% CI, 0.78-1.26), or live birth rates (adjusted odds ratio, 0.91; 95% CI, 0.79-1.06), in women who underwent frozen embryo transfer. Recurrent pregnancy loss history did not significantly predict either live birth rates (adjusted odds ratio, 0.99; 95% CI, 0.76-1.28) or miscarriage rates (adjusted odds ratio, 1.04; 95% CI, 0.81-1.35), in frozen embryo transfer cycles that resulted in clinical pregnancy. History of previous pregnancy loss did not significantly affect the fertility outcomes in all cycles ([adjusted odds ratio, 1.36; 95% CI, 0.88–2.10] for live birth rate and [adjusted odds ratio, 1.74; 95% CI, 0.75–4.01], for miscarriage rate); or in cycles that resulted in a clinical pregnancy ([adjusted odds ratio, 0.70; 95% CI, 0.31–1.63] for live birth rate and [adjusted odds ratio, 1.45; 95% CI, 0.58–3.63] for miscarriage rate)

Recurrent pregnancy loss history was not significantly associated with the miscarriage and live birth rates in women receiving fertility treatment who did not have obvious chromosome abnormalities or uterine malformations, indicating that it had little to no prognostic value in predicting the reproductive outcomes of frozen embryo transfer or intrauterine insemination cycles.

Reference: ajog.org/article/S0002-9378(22)00648-2/fulltext