A retrospective study on advanced maternal age and assisted reproductive techniques, medico-legal advice, "food for thought"

Background: Pregnancy in advanced reproductive age is nowadays part of the social and welfare scenario. The effects and assessment of the risks and complications in women over the age of 43 must still be more specifically defined. The aim of this study is to compare the outcomes between spontaneous pregnancies with those induced by assisted reproductive technology (ART) in women ≥ 43 years. Methods: This retrospective observational study enrolled 114 women with an age of ≥ 43 divided as follows: 74 with spontaneous pregnancies and 40 with ART-induced pregnancy. For statistical analysis, a t-test was used to compare the parameters analyzed for quantitative variables and χ2 was used for qualitative variables. A p-value ≤ 0.05 was considered statistically significant. Statistical Analysis was performed using the program SPSS 16.0 for Windows. Results: The statistically significant differences between IVF and spontaneous pregnancy groups were respectively: gestational hypertension (30% vs 6.8%), preeclampsia (17.5% vs 2.7%), preterm delivery (47.5% vs 13.5%), IUGR (17.5% vs 4.1%), caesarian section (95% vs 70.3%), length of recovery (8.6±7.2 vs 5.9±3) and mean birth weight (2641± 695 g vs 3207±496 g). Conclusion: Women in advanced reproductive age (≥ 43 years) who undergo assisted fertilization procedures are at a higher risk of complications compared to women of the same age with spontaneous pregnancies.