Am J Gastroenterol. 2023 Mar 20. doi: 10.14309/ajg.0000000000002252. Online ahead of print.
ABSTRACT
OBJECTIVES: There is a need for evidence-based counseling for women with chronic liver disease (LD) who may experience impaired fertility. Currently, the literature on assisted reproductive technology (ART) treatment in women with LD has been limited to a single European case series. We evaluated ART treatment outcomes in LD patients and compared to controls.
METHODS: The retrospective study evaluated women with and without LD who had normal ovarian reserve and underwent ART treatment in a high-volume fertility practice from 2002 to 2021.
RESULTS: We identified 295 women with LD (mean age 37.8 ± 5.2 years) who underwent 1,033 ART treatment cycles; of these women, 115 underwent 186 in vitro fertilization (IVF) cycles. Six (2.0%) women had cirrhosis, eight (2.7%) were post-liver transplantation and 281 (95.3%) had chronic LD, with viral hepatitis (B and C) being the most prevalent. In the subgroup who underwent IVF and embryo biopsy, the median FIB-4 score was 0.81 (0.58, 1.03), and there were no statistically significant differences in response to controlled ovarian stimulation, embryo fertilization rate or ploidy outcome in LD patients compared to controls. In those who subsequently underwent a single thawed euploid embryo transfer to achieve pregnancy, there were no statistically significant differences in rates of clinical pregnancy, clinical pregnancy loss or live birth in LD patients compared to controls.
CONCLUSIONS: To our knowledge, this study is the largest to date to evaluate IVF efficacy in women with LD. Our study demonstrates that patients with LD have similar ART treatment outcomes compared to those without LD.
PMID:36940434 | DOI:10.14309/ajg.0000000000002252
