# Incidence of cross-border reproductive care and pregnancy outcomes: a retrospective evaluation of IVF conceptions

## TL;DR

This study compared pregnancy outcomes for IVF conceptions done domestically versus cross-border, finding higher rates of hypertensive disorders in cross-border cases.

## Contribution

The study is one of the first to report on maternal outcomes specifically in cross-border IVF pregnancies.

## Key findings

- 24.2% of IVF pregnancies were conceived through cross-border reproductive care.
- Hypertensive disorders were significantly higher in cross-border IVF pregnancies (69.6%) compared to domestic (37.7%).
- Neonatal outcomes were similar between cross-border and domestic IVF pregnancies.

## Abstract

This study aimed to evaluate the incidence of cross-border reproductive care (CBRC) and maternal and neonatal outcomes in pregnancies conceived through in vitro fertilization (IVF), comparing outcomes between pregnancies conceived domestically and through CBRC.

A retrospective chart review was conducted on 4475 deliveries at a tertiary public hospital from February 1, 2023, to January 31, 2024. Maternal demographics, medical history, delivery outcomes, and complications were compared using statistical tests, with significance set at p < 0.05.

Among all deliveries, 95 were conceived via IVF. Among the IVF pregnancies, 23 (24.2%) were conceived through CBRC. While CBRC patients were older on average (40.3 vs. 37.8 years), this difference was not statistically significant (p = 0.07). The incidence of hypertensive disorders was significantly higher in CBRC pregnancies compared to domestic IVF pregnancies (69.6% vs. 37.7%, p = 0.01). Trends toward increased rates of postpartum hemorrhage (17.4% vs. 5.8%) and multiple gestations (26.1% vs. 11.6%) were also observed in the CBRC group, although these differences did not reach statistical significance. Neonatal outcomes, including rates of preterm birth, fetal growth restriction, and respiratory distress syndrome, were similar between the two groups.

The study highlights a significantly higher percentage of hypertensive disorders among CBRC pregnancies, while other maternal and neonatal outcomes were comparable to domestic IVF pregnancies. These findings underscore the need for further research with larger sample sizes and survey-based studies to better understand patient motivations and clinical risks associated with CBRC.