Background: Venous thromboembolism (VTE) in women with pregnancy from in vitro fertilization (IVF) has been reported in some studies and case reports, but the association needs to be confirmed.  

Aims: We aim to investigate the risk of VTE during pregnancy from IVF.

Methods: We systematically searched for observational studies about IVF and VTE from PubMed, Scopus, Science Direct, and ProQuest up to February 2021. The inclusion criteria was an observational study. The exclusion criteria were case report study and animal study. Risk ratio (RR) was calculated with 95% confidence interval (CI), while heterogeneity was assessed using the I² statistics. The primary outcome was VTE incidence during pregnancy. Data from eligible studies were pooled for effect estimates. Statistical analysis was performed using Review Manager software.

Results: A total of 5 articles were obtained with a total of 92,041 IVF patients and 2,733,664 non-IVF patients. Pooled analysis using random-effect model showed that IVF use was associated with a higher risk of VTE in all trimesters (RR: 2.27; 95% CI: 1.81-2.85; p: <0.00001; I²: 62%) (Figure 1). Sub-analysis in the first trimester also showed significant association between IVF and VTE (RR: 7.37; 95% CI: 4.83-11.23; p: <0.00001; I²: 78%). The funnel plot was symmetric, suggesting no publication bias.

Forest plot showing the risk ratio of VTE based on IVF vs non-IVF

Conclusions: This study showed that pregnancy from IVF is associated with higher VTE risk when compared to normal pregnancy.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/pregnancy-from-in-vitro-fertilization-is-associated-with-increase-in-risk-of-venous-thromboembolism-when-compared-to-normal-pregnancy-a-systematic-review-and-meta-analysis/