Einfluss der assistierten reproduktion auf geburtshilfe und neonatologie

Background: In industrialised countries, 1-4% of all children are born as a result of assisted reproductive therapies (ART), such as IVF and ICSI. Possible associations of these ARTs with obstetric and neonatal risk constellations are analysed critically in the context of this review. Methods: A selective literature search was conducted to examine the influence of ART on obstetric and neonatal aspects. Results: Multiple gestations, occurring more frequently after ART, are of special significance with regard to their associated risks. In comparison to spontaneous pregnancies, singleton gestations after ART are associated with higher rates of complications, such as preeclampsia, prematurity, low birth weight, foetal malformations and a higher rate of Caesarean sections. Although causal associations between extracorporeal fertilisation methods and health risks for mothers and infants in singleton pregnancies cannot be ruled out, these complications are rather attributed to the underlying causes of infertility than to the methods of assisted reproduction themselves. Conclusions: Pregnancies after ART are to be regarded as risk constellations with a need for closer surveillance during gestation irrespective of the number of developing foetuses. Couples seeking advice about infertility should be informed in detail before the onset of ART.