Document Detail


First-trimester screening markers are altered in pregnancies conceived after IVF/ICSI.
MedLine Citation:
PMID:  19115229     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine the levels of first-trimester screening markers and to assess the false-positive rate for first-trimester combined screening for Down syndrome in a large national population of women pregnant after assisted reproductive technology (ART), in order to decide whether or not to correct risk calculation for mode of conception. METHODS: A national prospective cohort study of 1000 pregnancies achieved after ART was compared with a control group of 2543 pregnancies conceived spontaneously. All women completed a first-trimester combined screening program. Risk calculation was performed retrospectively based on the screening parameters to avoid bias due to the use of different algorithms of risk calculation. RESULTS: In chromosomally normal pregnancies conceived after in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), the pregnancy-associated plasma protein-A multiples of the median value was significantly decreased when compared with that of pregnancies conceived spontaneously (0.78 and 0.79 vs. 0.98), while there was no difference in the group treated by frozen embryo replacement. There was no difference in the level of free beta-human chorionic gonadotropin between groups. The median nuchal translucency thickness was smaller in the overall ART group compared with controls. The false-positive rate of first-trimester combined screening in the overall ART group, adjusted for maternal age, was significantly higher when compared with controls (9.0% vs. 6.0%). CONCLUSIONS: It seems advisable to use a population of IVF/ICSI pregnancies to establish median curves for the first-trimester serum screening parameters and perhaps also for nuchal translucency thickness. However, care must be taken, as different ART treatment methods and aspects of medical history seem to alter the screening parameters in different ways.
Authors:
A C Gjerris; A Loft; A Pinborg; M Christiansen; A Tabor
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  33     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-05     Completed Date:  2009-09-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  8-17     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2008 ISUOG.
Affiliation:
Department of Fetal Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. ac@gjerris.dk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Biological Markers / blood
Chorionic Gonadotropin, beta Subunit, Human / blood*
Down Syndrome / blood,  diagnosis*
False Positive Reactions
Female
Fertilization in Vitro*
Humans
Middle Aged
Pregnancy
Pregnancy Trimester, First / blood
Pregnancy-Associated Plasma Protein-A / metabolism*
Prenatal Diagnosis / methods,  standards*
Reference Values
Risk Assessment / methods,  standards
Sperm Injections, Intracytoplasmic
Young Adult
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Chorionic Gonadotropin, beta Subunit, Human; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

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