COMPLICATIONS OF MEDICALLY ASSISTED CONCEPTION IN 3,500 CYCLES

Objective: To investigate the incidence of complications in the use of assisted reproductive technology in the management of infertile coupl es. Design: Retrospective study. Setting: The Egyptian IVF & ET Center , Maadi, Cairo, Egypt. Patient(s): Two thousand nine hundred twenty-fo ur patients underwent IVF-ET or intracytoplasmic sperm injection (ICSI ) in 3,500 cycles. Intervention(s): NF-ET, ICSI, ejaculate sperm, epid idymal sperm aspiration, and testicular sperm extraction. Main Outcome Measure(s): Complications of the procedure and complications of pregn ancy in 702 patients. Result(s): Fifteen hundred ovum pickups for IVF- ET and 2,000 ovum pickups for ICSI were performed. Clinical pregnancy occurred in 1,078 patients (30.8%). Four groups of complications were identified. Complications of the procedure occurred in 291 patients (8 .3%). Complications of pregnancy included ectopic pregnancy in 1.9%, h eterotopic pregnancy in 0.2%, abortion in 20.6%, multiple pregnancy in 28%, pregnancy-induced hypertension in 10%, preterm labor in 21.5%, l ow birth weight in 30.5%, and intrauterine death in 2%. Coincidental c omplications occurred in five patients (0.15%). Other complications th at were difficult to measure included psychological breakdown and soci oeconomic problems. Conclusion(s): Assisted reproductive technology is effective for the management of infertility and has an acceptable inc idence of complications. Complications rarely endanger the life of the patient. When this line of treatment is offered, the indications shou ld be definitive. Patients should be monitored properly and measures s hould be taken to minimize the incidence of complications. (Fertil Ste ril(R) 1998;70:638-42. (C) 1998 by American Society for Reproductive M edicine.).