Lower cesarean section rate in singeltons born after gonadotropin-free in vitro fertilization (NC-IVF) compared to conventional IVF

Cesarean section (CS) rate is known to be high in an infertile population because of multiple reasons. Differences in maternal characteristics such as age, parity or subfertility reasons are of importance. In NC-IVF embryos showed a better quality, implantation is improved due to increased endometrium receptivity. However little is known about the obstetrical outcomes in NC-IVF compared to conventional IVF (cIVF) conceived pregnancies.

Retrospective analysis of singelton pregnancies after IVF treatment with fresh embryo transfers. All women (18 – 42 years) with regular cycles choose NC-IVF or cIVF. NC-IVF was performed without any gonadotropins, cIVF as a short agonist or antagonist protocol. Obstetrical and delivery data were extracted from patient's files.

Complete data sets were identified for 62 NC-IVF and 41 cIVF singelton deliveries. Gestational age at delivery, prematurity, low birth weight and mean birth weight of NC-IVF vs. cIVF children were not different. In contrast, the proportion of women intending to deliver vaginally was significantly higher (85% vs. 67.5%, p = 0.035) after NC-IVF than after cIVF. CS rate in pregnancies following NC-IVF were lower compared to cIVF (38.7% vs. 53.7%, p = 0.098).

Women choosing NC-IVF intended significantly more often to deliver spontaneously. It should be examined if this is due to the attitude concerning delivery mode or because of fear following cIVF, or if gonadotropin affects the endometrial receptivity inducing changes in obstetrical and perinatal outcome. In conclusion our study has shown that delivery parameters are in favour of NC-IVF, so this kind of treatment can be an alternative.