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Assisted Reproduction Safety and Risks

Complications related to in vitro reproductive techniques support the implementation of natural procreative technologies

Kiani AK, Paolacci S, Scanzano P, Michelini S, Capodicasa N, D'Agruma L, Notarangelo A, Tonini G, Piccinelli D, Farshid KR, Petralia P, Fulcheri E, Chiurazzi P, Terranova C, Plotti F, Angioli R, Castori M, Bertelli M

Published November 9, 2020 Acta Bio-medica : Atenei Parmensis, 91(13-S), e2020018
DOI 10.23750/abm.v91i13-S.10525 PMID 33170179 PMC PMC8023144

RRM Academy Synopsis

ART complications for mothers and children support NaProTechnology

A 2020 narrative review of literature published through August 2019 reports that ART may be associated with higher risks of complications for mothers and offspring. The review describes NaProTechnology live birth rates as similar to ART. In a 2008 study of 1239 infertile couples, about 5 out of 10 treated with NaProTechnology had a live birth within 24 months.

About 5 in 10 couples treated with NaProTechnology had a live birth within 24 months
About 5 in 10 couples treated with NaProTechnology had a live birth within 24 months. Source: Kiani AK et al., 2020, PMID 33170179.

Key Findings

  • A Netherlands study cited in the review found a mortality rate of 42 deaths per 100000 in ART pregnancies, against 6 deaths per 100000 in normal pregnancies.
  • Ectopic pregnancy rates range from 1% to 8.6% after ART against 1% to 2% with normal conception; ovarian hyperstimulation syndrome risk may range from 3% to 10% in ART cycles.
  • A meta-analysis of 12283 ART-conceived and 1.9 million normally conceived singleton infants found significantly higher perinatal mortality, preterm births, small-for-gestational-age status and low or very low birth weight in the ART group.
  • A 2008 study of 1239 infertile couples treated with NaProTechnology found that 52.8% had a live birth within 24 months, with a live birth rate similar to the ART-treated group.
  • The review reports that genetic factors appear to determine infertility in about 50% of cases.

Interpretation

This narrative review searched PubMed for English-language articles published until August 2019 on ART complications and the NaProTechnology approach. The complication figures come from separate studies cited in the review, such as a Netherlands study and a meta-analysis. Table 1 gives the authors' qualitative comparison of ART and NaProTechnology on cost, complication risks and genetic counseling. The findings support larger studies comparing outcomes between the two approaches.

RRM Context

Restorative reproductive medicine looks for the cause of infertility and treats it, so that pregnancy can follow from intercourse. ART bypasses the reproductive system without establishing why conception fails. NaProTechnology applies the restorative principle with Creighton Model FertilityCare System charting of fertile days, together with medical and surgical treatment. The review proposes genetic testing of couples as part of the search for causes.

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

Abstract

Background and Aims

Infertility affects ~20% of the couples in the world. Assisted reproductive technologies (ARTs) are currently the most common treatment option for infertility. Nevertheless, ARTs may be associated with complications for mothers and/or offspring. Natural procreative technology (NaProTechnology) is a natural treatment which minimizes these risks by seeking to identify the causes of infertility to enable better treatments. This narrative review summarizes the complications related to ARTs and clarifies how the NaProTechnology approach can help ARTs to achieve better results or be used in alternative to ARTs.

Methods

Data in the literature indicate that NaProTechnology is a natural approach for treating infertility.

Results

The percentage of live births obtained by NaProTechnology is similar to that of ARTs.

Conclusions

An extensive search for the genetic defects causing infertility or subfertility through genetic testing can help both ARTs and NaProTechnology to achieve successful pregnancies. By discovering the underlying causes of infertility, genetic tests enable better family counseling, like the implications of transmitting risk- and disease-alleles to future generations.

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Topics

By this author

Related research

Assisted Reproduction › Safety and Risks › Procedural Safety · Restorative Reproductive Medicine › NaProTechnology › Program Outcomes
Aysha Karim Kiani, Stefano Paolacci, Pietro Scanzano, Sandro Michelini, Natale Capodicasa, Leonardo D'Agruma, Angelantonio Notarangelo, Gerolamo Tonini, Daniela Piccinelli, Kalantary Rad Farshid, Paolo Petralia, Ezio Fulcheri, Pietro Chiurazzi, Corrado Terranova, Francesco Plotti, Roberto Angioli, Marco Castori, Matteo Bertelli
A Kiani, S Paolacci, P Scanzano, S Michelini, N Capodicasa, L D'Agruma, A Notarangelo, G Tonini, D Piccinelli, K Farshid, P Petralia, E Fulcheri, P Chiurazzi, C Terranova, F Plotti, R Angioli, M Castori, M Bertelli
PMID 33170179 33170179 DOI 10.23750/abm.v91i13-S.10525 10.23750/abm.v91i13-S.10525 Kiani et al. 2020, Kiani 2020

Keywords

Female, Genetic Testing, Humans, Infertility, Pregnancy, Reproductive Techniques, Assisted/adverse Effects, Technology

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