The Fertility Society of Australia is the funding body for the Australian and New Zealand Assisted Reproduction Database. The authors acknowledge the contribution of fertility clinics in Australia and New Zealand in the provision of data to the Australian and New Zealand Assisted Reproduction Database. This article is based on data made available by the Australian Institute of Health and Welfare. The authors are responsible for the data used in this article.
Population-Based Study of Cesarean Section After In Vitro Fertilization in Australia
Article first published online: 2 SEP 2010
© 2010, Copyright the Authors. Journal compilation © 2010, Wiley Periodicals, Inc.
Volume 37, Issue 3, pages 184–191, September 2010
How to Cite
Sullivan, E. A., Chapman, M. G., Wang, Y. A. and Adamson, G. D. (2010), Population-Based Study of Cesarean Section After In Vitro Fertilization in Australia. Birth, 37: 184–191. doi: 10.1111/j.1523-536X.2010.00405.x
- Issue published online: 2 SEP 2010
- Article first published online: 2 SEP 2010
- Accepted September 29, 2009
- cesarean section;
- embryo transfer;
- in vitro fertilization;
- intracytoplasmic sperm injection
Abstract: Background: Decisions about method of birth should be evidence based. In Australia, the rising rate of cesarean section has not been limited to births after spontaneous conception. This study aimed to investigate cesarean section among women giving birth after in vitro fertilization (IVF).
Methods: Retrospective population-based study was conducted using national registry data on IVF treatment. The study included 17,019 women who underwent IVF treatment during 2003 to 2005 and a national comparison population of women who gave birth in Australia. The outcome measure was cesarean section.
Results: Crude rate of cesarean section was 50.1 percent versus 28.9 percent for all other births. Single embryo transfer was associated with the lowest (40.7%) rate of cesarean section. Donor status and twin gestation were associated with significantly higher rates of cesarean section (autologous, 49.0% vs donor, 74.9%; AOR: 2.20, 95% CI: 1.80, 2.69) and (singleton, 45.0% vs twin gestations, 75.7%; AOR: 3.81, 95% CI: 3.46, 4.20). The gestation-specific rate (60.1%) of cesarean section peaked at 38 weeks for singleton term pregnancies. Compared with other women, cesarean section rates for assisted reproductive technology term singletons (27.8% vs 43.8%, OR: 2.02 [95% CI: 1.95–2.10]) and twins (62.0% vs 75.7%, OR: 1.92 [95% CI: 1.74–2.11]) were significantly higher.
Conclusions: Rates for cesarean section appear to be disproportionately high in term singleton births after assisted reproductive technology. Vaginal birth should be supported and the indications for cesarean section evidence based. (BIRTH 37:3 September 2010)