Mortality in Women Treated With Assisted Reproductive Technology-Addressing the Healthy Patient Effect

American Journal of Epidemiology
Ditte VassardMads Kamper-Jørgensen

Abstract

In previous studies, investigators have reported reduced mortality among women undergoing assisted reproductive technology (ART) treatment, possibly related to selection of healthy women into ART treatment. Our aim in this study was to explore the impact of relevant selection factors on the association between ART treatment and mortality and to explore effect modification by parity. Women treated with ART in fertility clinics in Denmark during 1994-2009 (n = 42,897) were age-matched with untreated women from the background population (n = 204,514) and followed until December 31, 2010. With adjustment for relevant confounders, the risk of death was lower among ART-treated women during the first 2 years after ART treatment (hazard ratio (HR) = 0.68, 95% confidence interval (CI): 0.63, 0.74), but there was no apparent difference after 10 years (HR = 0.92, 95% CI: 0.79, 1.07). Having children prior to ART treatment was associated with markedly reduced mortality (HR = 0.45, 95% CI: 0.38, 0.53), possibly due to better health among fertile women. While the frequencies of previous medical and psychiatric diagnoses among ART-treated and untreated women were similar, differences in disease severity could explain the reduced mortality amo...Continue Reading

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Citations

Oct 28, 2018·Journal of the Chinese Medical Association : JCMA·Fa-Kung LeePeng-Hui Wang
Nov 15, 2019·Human Reproduction·Clara Helene GlazerJens Peter Bonde
Feb 8, 2021·European Journal of Obstetrics, Gynecology, and Reproductive Biology·G M Hviid MallingL Schmidt
Feb 13, 2021·American Journal of Obstetrics and Gynecology·Gayathree MurugappanMichael L Eisenberg

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