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Safety and efficacy of in vitro fertilisation in patients with chronic liver disease and liver transplantation recipients

Journal of Hepatology Jan 20, 2021

Rahim MN, Theocharidou E, Lau KGY, et al. - In patients with chronic liver disease, cirrhosis, or post-liver transplantation (LT), researchers conducted this retrospective analysis to report the largest experience of IVF in women with liver-related subfertility (LRSF). The sample consisted of 42 women with LRSF who had undergone 57 IVF cycles between 1990-2019. Forty-two women with LRSF received IVF; 9 cycles in 6 women with cirrhosis, 14 cycles in 11 women post-LT and 34 cycles in 25 women without cirrhosis. In selected cases, IVF may be successful in women with LRSF. Patients should be advised, however, on the potential increased risks of ovarian hyperstimulation syndrome, obstetric cholestasis and prematurity. There have been no maternal deaths. Of 57 IVF cycles evaluated, 43 (75%) resulted in successful implantation and eight (2 post-LT, 3 cirrhotic, 4 non-cirrhotic) resulted in miscarriage. The live birth rate (LBR) was 74% (32/43). Unsuccessful IVF attempts for cirrhotics were 2/9 (22%), for post-LT 4/14 (29%) and for non-cirrhotics 6/34 (18%). There were 9/57 (16%) IVF cycles that resulted in new liver enzyme derangement during therapy, which improved following treatment completion. Six pregnancies (2 LT, 4 non-cirrhotic) were complicated by obstetric cholestasis (OC). Ovarian hyperstimulation syndrome (OHSS) was rare (n=3, 7%). 

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