Additive effect of factors related to assisted conception on the reduction of maternal serum pregnancy-associated plasma protein A concentrations and the increased false-positive rates in first-trimester Down syndrome screening.

6533b7d8fe1ef96bd126a3d2

RESEARCH PRODUCT

Additive effect of factors related to assisted conception on the reduction of maternal serum pregnancy-associated plasma protein A concentrations and the increased false-positive rates in first-trimester Down syndrome screening.

José Remohí José Bellver C. Lara Antonio Pellicer Cristina Casanova Vicente Serra Nicolás Garrido

subject

medicine.medical_specialty Pregnancy-associated plasma protein A Reproductive Techniques Assisted medicine.medical_treatment Down-Regulation Fertilization in Vitro Intracytoplasmic sperm injection Embryo cryopreservation Predictive Value of Tests Pregnancy Prenatal Diagnosis medicine Humans Pregnancy-Associated Plasma Protein-A Chorionic Gonadotropin beta Subunit Human False Positive Reactions reproductive and urinary physiology Insemination Artificial Retrospective Studies Gynecology Down syndrome screening Analysis of Variance Chi-Square Distribution Oocyte Donation business.industry Singleton Free βhcg Obstetrics and Gynecology Pregnancy Trimester First Reproductive Medicine Cohort Female Hormone therapy Down Syndrome business Nuchal Translucency Measurement Biomarkers

description

Objective To analyze whether assisted conceptions need adjustments in first-trimester Down syndrome screening and why modifications in screening markers occur. Design Eleven-year cohort retrospective analysis. Setting Maternal-fetal medicine unit. Patient(s) Two thousand eleven naturally conceived normal singleton pregnancies and 2,042 normal singleton pregnancies achieved with assisted conception: 350 by IUI and 1,692 with IVF (n = 328) or intracytoplasmic sperm injection (ICSI; n=1,364), using nondonor (n = 1,086) or donated ova (n = 606), with fresh (n = 1,432) or frozen (n = 260) embryos. Intervention(s) Comparison of ultrasound and biochemical markers of first-trimester Down syndrome screening according to the mode of conception and considering the clinical and laboratory parameters related. Main Outcome Measure(s) Nuchal translucency (NT), PAPP-A and free βhCG maternal serum concentrations, and false-positive rates (FPRs). Result(s) NT is unaffected by the mode of conception. Singleton pregnancies achieved by IVF and ICSI with nondonor oocytes have reduced maternal serum PAPP-A and increased FPR, which are significant only in ICSI cycles. Pregnancies from frozen embryos with hormone therapy also show decreased PAPP-A but without affecting the FPR. Elevated maternal serum fβhCG levels in oocyte donation do not influence the FPR. Conclusion(s) Among assisted conceptions, only nondonor IVF/ICSI singleton pregnancies need adjustments of the maternal serum PAPP-A in first-trimester Down syndrome screening.

year	journal	country	edition	language
2013-04-03	Fertility and sterility

10.1016/j.fertnstert.2013.06.045 https://pubmed.ncbi.nlm.nih.gov/24462058