2 research outputs found
Adverse childhood experiences are associated with increased risk of miscarriage in a national population-based cohort study in England
STUDY QUESTION: Is there an association between adverse childhood experiences (ACE) and the risk of miscarriage in the general population? SUMMARY ANSWER: Specific ACE as well as the summary ACE score were associated with an increased risk of single and recurrent miscarriages. WHAT IS KNOWN ALREADY: There is scarce evidence on the association between ACE and miscarriage risk. STUDY DESIGN, SIZE, DURATION: We conducted a retrospective national cohort study. The sample consisted of 2795 women aged 55-89 years from the English Longitudinal Study of Ageing (ELSA). PARTICIPANTS/MATERIALS, SETTING, METHODS: Our study was population-based and included women who participated in the ELSA Life History Interview in 2007. We estimated multinomial logistic regression models of the associations of the summary ACE score and eight individual ACE variables (pertaining to physical and sexual abuse, family dysfunction and experiences of living in residential care or with foster parents) with self-reported miscarriage (0, 1, ≥2 miscarriages). MAIN RESULTS AND THE ROLE OF CHANCE: Five hundred and fifty-three women (19.8% of our sample) had experienced at least one miscarriage in their lifetime. Compared with women with no ACE, women with ≥3 ACE were two times more likely to experience a single miscarriage in their lifetime (relative risk ratio 2.00, 95% CI 1.25-3.22) and more than three times more likely to experience recurrent miscarriages (≥2 miscarriages) (relative risk ratio 3.10, 95% CI 1.63, 5.89) after adjustment for birth cohort, age at menarche and childhood socioeconomic position. Childhood experiences of physical and sexual abuse were individually associated with increased risk of miscarriage. LIMITATIONS, REASONS FOR CAUTION: Given the magnitude of the observed associations, their biological plausibility, temporal order and consistency with evidence suggesting a positive association between ACE and adverse reproductive outcomes, it is unlikely that our findings are spurious. Nevertheless, the observed associations should not be interpreted as causal as our study was observational and potentially susceptible to bias arising from unaccounted confounders. Non-response and ensuing selection bias may have also biased our findings. Retrospectively measured ACE are known to be susceptible to underreporting. Our study may have misclassified cases of ACE and possibly underestimated the magnitude of the association between ACE and the risk of miscarriage. WIDER IMPLICATIONS OF THE FINDINGS: Our study highlights experiences of psychosocial adversity in childhood as a potential risk factor for single and recurrent miscarriages. Our findings contribute to a better understanding of the role of childhood trauma in miscarriage and add an important life course dimension to the study of miscarriage. STUDY FUNDING/COMPETING INTEREST(S): ELSA is currently funded by the National Institute on Aging in USA (R01AG017644) and a consortium of UK government departments coordinated by the National Institute for Health Research. The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the article. The authors have no actual or potential competing financial interests to disclose
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Double vitrification and warming of blastocysts does not affect IVF implantation rates, or birth outcomes
Research question: Does double blastocyst vitrification and warming affect pregnancy rates from embryos subjected to PGT-A testing?
Design: This is a retrospective observational analysis of embryo transfers performed at a single Centre between January 2017 and August 2022. The double vitrification (DV) group included frozen blastocysts that were vitrified after 5-7 days of culture, warmed, biopsied (either once or twice) and re-vitrified. The single vitrification (SV) group included fresh blastocysts that were biopsied at 5-7 days, and then vitrified.
Results: Comparison of the 84 DV blastocysts and 729 control SV blastocysts indicated that the DV embryos were frozen later in development and had expanded more than the SV embryos. Of the 813 embryo transfer procedures reported in this study, 452 resulted in the successful delivery of healthy infants (56%). There were however no significant differences between DV and SV embryos in the pregnancy rates achieved after single embryo transfer (55% vs 56%). Logistic regression indicated that while reduced pregnancy rates were associated with increasing maternal age at oocyte collection and at embryo transfer, and with longer culture prior to freezing, DV was not a significant predictor of outcome.
Conclusions: Blastocyst DV was not shown to impact pregnancy rates. While caution is necessary due to the study size, no effects of DV on miscarriage rates, birth weight or gestation period were noted. These data offer reassurance given the absence of influence of DV on pregnancy rates after PGT-A