Abstract
[Truncated abstract] Introduction In vitro fertilization (IVF) has seen exponential growth since 1978 with the birth of the first IVF baby. Around 4% of all babies born in Australia are now conceived through IVF. Yet we still do not have a full understanding of how effective IVF is in routine practice or the potential long-term risks of the treatment. The aim of this thesis was twofold: firstly, to examine IVF effectiveness, per woman, and secondly, to consider the association of IVF treatment with long term risks of breast and ovarian cancer, borderline ovarian tumours and melanoma. Methods The studies reported here made use of the resources of the Western Australian (WA) Data Linkage System to identify women undergoing infertility treatment and IVF, to identify potential risk factors and outcomes of interest and to link together the relevant records. The following WA data collections were accessed: the Hospital Morbidity Data System, the Reproductive Technology Register, the Cancer Registry, the Midwives' Register, the Deaths Register and the Electoral Roll. Whole-population cohort studies were undertaken. The first study included all women commencing IVF in Western Australia between 1982 and 2002. The remaining studies included all women commencing hospital infertility treatment (including IVF). IVF effectiveness was measured by plotting two sets of survival curves using the life-table method. The first set plotted the probability of a live delivery over time and the second set plotted the probability of live delivery according to the number of cycles attempted. Hazard ratios for cancer outcomes, comparing women who had infertility treatment including IVF with women who had infertility treatment but not IVF, were estimated using Cox regression analysis. Results IVF treatment was found to be 47% effective overall for women who commenced IVF between 1993 and 2002. If treatment-independent births were included, this figure rose to 63%.
| Original language | English |
|---|---|
| Qualification | Doctor of Philosophy |
| Publication status | Unpublished - 2013 |
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