P-734 Full population analysis of health impacts associated with in vitro fertilization (IVF) treatments in reproductive-aged women: Evidence from South Korea’s national health insurance data

Abstract Study question What are the short and long term health impacts of in vitro fertilization (IVF) treatments on reproductive-aged women? Summary answer IVF increases short-term depression risks and mid-to long-term health risks like ovarian dysfunction, cancer, anxiety, and pregnancy-related complications, requiring comprehensive physical and mental health support. What is known already Previous studies have shown that IVF is linked to both mental and physical health challenges. However, comprehensive research examining the broader physical and reproductive health impacts of IVF in a large national sample has been lacking. This study bridges that gap by providing extensive data on the short-term and long-term health risks associated with IVF, emphasizing the need for integrated fertility care that addresses both physical and mental health concerns. The findings support the necessity of comprehensive support systems for women undergoing IVF to mitigate these risks. Study design, size, duration Using customized National Health Insurance Service DB data from 2018-2022 in South Korea, we analyzed various groups: (1) IVF group vs. control group. (2) All infertility treatment women vs. control group. (3) Infertility treatment pregnant women vs. control pregnant women. (4) Pregnant vs. non-pregnant within infertility treatment group. (5) Disease diagnosis comparison by infertility treatment frequency and age group Participants/materials, setting, methods We conducted a retrospective study using data from the National Health Insurance Service in South Korea from 2018 to 2022. Our study reviewed 230,147 women who underwent IVF and a control group of 1,026,181 women matched by age. Main results and the role of chance The study results showed that the average age of the infertility treatment group was significantly higher than that of the control group, with a higher average health insurance premium. The proportion of employees in the infertility treatment group was 82%, compared to 76% in the control group, while the medical aid ratio was lower (17% vs. 23%). More women in the infertility treatment group resided in Seoul and the metropolitan area. Cox proportional hazard analysis revealed higher short-term risks of depression (within 2 years) and higher mid-to long-term risks of ovarian cancer, POI, DOR, PCOS, anxiety disorders, endometriosis, uterine fibroids, and breast cancer in the infertility treatment group. When comparing IVF-pregnant and naturally pregnant groups, the IVF-pregnant group showed higher risks for pregnancy-related complications (e.g., miscarriage, preterm birth, gestational diabetes, hypertension) and ovarian dysfunction. The non-pregnant group had a slightly higher frequency of depression. The pregnancy group had a significantly lower average age and a longer infertility duration. Non-smokers predominated in both groups. The pregnancy group’s endometriosis diagnosis rate was higher (3.56% vs. 3.08%). Logistic results showed decreased pregnancy probability with increased age and treatment frequency, with metropolitan residents having higher probabilities but slightly lower in Seoul. Limitations, reasons for caution The study may have limitations related to potential confounding variables that were not accounted for, and the observational nature of the study design may limit the ability to establish causality. Wider implications of the findings This research emphasizes the importance of integrated fertility care that addresses long-term health outcomes for women undergoing IVF. Comprehensive support should include both physical and mental health considerations to mitigate the increased risks associated with IVF. Trial registration number No