Newest scholarly works
Camera trocar lifting in office gasless laparoscopic sterilization under local anesthesia Acta obstetricia et gynecologica Scandinavica · 2010 Systematic review and metaanalysis of intraperitoneal instillation of local anesthetics for reduction of pain after gynecologic laparoscopy Journal of minimally invasive gynecology · 2012 Ultrasound Visceral Slide Assessment to Evaluate for Intra-abdominal Adhesions in Patients Undergoing Abdominal Surgery - A Systematic Review and Meta-analysis Journal of minimally invasive gynecology · 2021
All works
Original research
Systematic Mapping of the Abdomen and Pelvis (S-MAP) IIRRM 2026 · poster A three-axis framework for reproductive impairment IIRRM 2026 · poster The ART Reporting Completeness (ARC) Framework IIRRM 2026 · poster
All original research
Get a free library card
Save papers, follow topics, and connect the library to Claude or ChatGPT.
Sign up free
Commentary
Where Did the Vitamin A Go? What Changed in Cereal, Milk and the American Plate Naomi Whittaker, MD and Pam Schoenfeld, MS, RD, LDN · Oct 20
All 22 guides Plain-language guides to the methods, the conditions, and what the evidence shows.
All commentary
Breaking Up with IVF FreeMidwife and former front-line IVF clinician Dr. Jennifer Mercier joins Dr. Naomi Whittaker for a candid Save the Uterus Club conversation. Masterclass in Endometriosis & Surgery 9 sectionsComprehensive guide for patients preparing for endometriosis surgery. Hormones Through the Lifespan FreeA comprehensive overview of hormonal health across a woman's life, menstrual cycles, common conditions, and the transition to menopause, presented by Dr. Ana Garcia, OB/GYN.
All 20 courses Endometriosis For clinicians
Member courses and live calls
Join Save the Uterus Club: live calls with Dr. Whittaker, member courses, discussion.
Become a member
Save the Uterus Club
Save the Uterus Club The community and collaboration arm of RRM Academy: live calls, new research, advocacy taking shape. Become a member

Assisted Reproduction Safety and Risks

Assisted reproductive technology and the risk of preeclampsia: an updated systematic review and meta-analysis

Almasi-Hashiani A, Omani-Samani R, Mohammadi M, Amini P, Navid B, Alizadeh A, Khedmati Morasae E, Maroufizadeh S

Published May 2, 2019 BMC Pregnancy and Childbirth, 19(1), 149
DOI 10.1186/s12884-019-2291-x PMID 31046710 PMC PMC6498659

RRM Academy Synopsis

Assisted Reproductive Technology Linked to Higher Preeclampsia Risk

ART was linked to a 71 percent higher risk of preeclampsia than pregnancies without it (relative risk 1.71, 95% CI 1.11 to 2.62). The finding comes from a meta-analysis of 48 studies covering more than 6.7 million pregnancies.

Key Findings

  • The meta-analysis combined 48 studies published from 1999 to 2017, covering 156,246 ART pregnancies (14,560 with preeclampsia) and 6,558,249 non-ART pregnancies (202,064 with preeclampsia).
  • The pooled relative risk for preeclampsia with ART was 1.71 (95% CI 1.11 to 2.62, p = 0.015), using a random-effects model.
  • The association was significant among the 43 cohort studies (RR 1.73, 95% CI 1.10 to 2.72) but not among the 5 case-control studies (RR 1.46, 95% CI 0.97 to 2.20).
  • The association was not statistically significant among the 26 European studies (RR 1.74, 95% CI 0.95 to 3.21), unlike the Asian and American subgroups.
  • Begg's test (p = 0.001) and an asymmetrical funnel plot indicated evidence of publication bias among the included studies.

Interpretation

This is a meta-analysis of 48 observational studies on assisted reproductive technology (ART) and preeclampsia. The design can show a link between ART and preeclampsia but cannot prove that one causes the other. Heterogeneity among the studies was very high (I2 99.8%), and the authors found evidence of publication bias. The review could not separate singleton from twin pregnancies or adjust for known confounders such as maternal age or obesity. The authors also limited the search to English-language papers, which may have added bias.

RRM Context

Preeclampsia is one of several pregnancy risks linked to ART, along with preterm birth and low birth weight. Restorative reproductive medicine looks for the underlying cause of infertility, guided by cycle charting. Findings on added risk with ART add to the evidence patients and doctors can weigh when choosing how to approach infertility care.

Our editorial summary of this paper, not the article's abstract.

Abstract

Background

The objective of this systematic review and meta-analyses was to assess the risk of preeclampsia among women who conceived with assisted reproductive technology (ART).

Methods

We searched the ISI Web of Knowledge, Medline/PubMed, Scopus, and Embase (from inception to May 2017) for English language articles using a list of key words. In addition, reference lists from identified studies and relevant review articles were also searched. Data extraction was performed by two authors, and the study quality was assessed using the Newcastle-Ottawa Scale. Random-effects model meta-analysis was applied to pool the relative risks (RR) across studies.

Results

A total of 48 studies (5 case-control studies and 43 cohort studies) were included in this meta-analysis. The Cochran Q test and I(2) statistics revealed substantial heterogeneity (Q = 26,313.92, d.f. = 47, p < 0.001 and I(2) = 99.8%). Meta-analysis showed a significant increase in preeclampsia in women who conceived by ART compared with those who conceived spontaneously (RR = 1.71, 95% CI = 1.11-2.62, p = 0.015).

Conclusions

The findings of this systematic review indicate that the use of ART treatment is associated with a 1.71-fold increase in preeclampsia.

Topics

By this author

Related research

Assisted Reproduction › Safety and Risks › Maternal Complications · Pregnancy › Pregnancy Complications › Hypertensive Disorders · Birth and Delivery › Birth Outcomes › Maternal Morbidity
Amir Almasi-Hashiani, Reza Omani-Samani, Maryam Mohammadi, Payam Amini, Behnaz Navid, Ahad Alizadeh, Esmaeil Khedmati Morasae, Saman Maroufizadeh
A Almasi-Hashiani, R Omani-Samani, M Mohammadi, P Amini, B Navid, A Alizadeh, E Morasae, S Maroufizadeh
PMID 31046710 31046710 DOI 10.1186/s12884-019-2291-x 10.1186/s12884-019-2291-x Almasi-Hashiani et al. 2019, Almasi-Hashiani 2019

Learn

Resources

Tools

Help

Candid Platinum Transparency 2026

RRM Academy is a 501(c)(3) nonprofit providing free and low-cost education in restorative reproductive medicine for patients and healthcare professionals.

This site is an educational resource and does not provide medical advice. Inclusion of a study does not imply endorsement of its findings. Always consult a qualified healthcare provider for diagnosis and treatment.

© 2026 RRM Academy · All Rights Reserved

Restorative Reproductive Medicine Foundation · 3401 Hartzdale Dr, Ste 103B PMB 3518, Camp Hill, PA 17011 · EIN: 93-4594315
Sitemap AI Instructions Developers Terms of Use Medical Disclaimer Privacy Policy