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

被引：28

作者：

Bellver, Jose ^{[1
,2
]}

Casanova, Cristina ^{[1
]}

Garrido, Nicolas ^{[1
]}

Lara, Coral ^{[1
]}

Remohi, Jose ^{[1
,2
]}

Pellicer, Antonio ^{[1
,2
]}

Serra, Vicente ^{[1
,2
]}

机构：

[1] Inst Valenciano Infertilidad, Valencia 46015, Spain

[2] Univ Valencia, Fac Med, Dept Pediat Obstet & Ginecol, Valencia, Spain

来源：

FERTILITY AND STERILITY | 2013年 / 100卷 / 05期

关键词：

First-trimester Down's syndrome screening; free beta hCG; PAPP-A; assisted conception; false-positive rates; REPRODUCTIVE TECHNOLOGIES ART; HUMAN CHORIONIC-GONADOTROPIN; ALPHA-FETOPROTEIN LEVELS; IN-VITRO FERTILIZATION; FREE BETA-HCG; SINGLETON PREGNANCIES; NUCHAL TRANSLUCENCY; PAPP-A; GESTATIONAL-AGE; MARKERS;

D O I：

10.1016/j.fertnstert.2013.06.045

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

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 beta hCG 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 f beta hCG 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. (C) 2013 by American Society for Reproductive Medicine.

引用

页码：1314 / +

页数：10

共 38 条

[1] Pregnancies conceived using assisted reproductive technologies (ART) have low levels of pregnancy-associated plasma protein-A (PAPP-A) leading to a high rate of false-positive results in first trimester screening for Down syndrome [J].

Amor, D. J. ;

Xu, J. X. ;

Halliday, J. L. ;

Francis, I. ;

Healy, D. L. ;

Breheny, S. ;

Baker, H. W. G. ;

Jaques, A. M. .

HUMAN REPRODUCTION, 2009, 24 (06) :1330-1338

[2] First trimester screening for Down's syndrome after assisted reproductive technology: non-male factor infertility is associated with elevated free beta-human chorionic gonadotropin levels at 10-14 weeks of gestation [J].

Anckaert, Ellen ;

Schiettecatte, Johan ;

Sleurs, Elke ;

Devroey, Paul ;

Smitz, Johan .

FERTILITY AND STERILITY, 2008, 90 (04) :1206-1210

[3] Review: Biochemical markers to predict preeclampsia [J].

Anderson, U. D. ;

Olsson, M. G. ;

Kristensen, K. H. ;

Akerstrom, B. ;

Hansson, S. R. .

PLACENTA, 2012, 33 :S42-S47

[4] First trimester biochemical screening for Down's syndrome in singleton pregnancies conceived by assisted reproduction [J].

Bellver, J ;

Lara, C ;

Soares, SR ;

Ramírez, A ;

Pellicer, A ;

Remohí, J ;

Serra, V .

HUMAN REPRODUCTION, 2005, 20 (09) :2623-2627

[5] Altered first-trimester screening markers after IVF/ICSI: no relationship with small-for-gestational-age and number of embryos transferred [J].

Bender, F. ;

Hecken, J. ;

Reinsberg, J. ;

Berg, C. ;

van der Ven, H. ;

Gembruch, U. ;

Geipel, A. .

REPRODUCTIVE BIOMEDICINE ONLINE, 2010, 20 (04) :516-522

[6] Maternal serum levels of placental proteins after in vitro fertilisation and their implications for prenatal screening [J].

Bersinger, NA ;

Wunder, D ;

Vanderlick, F ;

Chanson, A ;

Pescia, G ;

Janecek, P ;

Boillat, E ;

Birkhäuser, MH .

PRENATAL DIAGNOSIS, 2004, 24 (06) :471-477

[7] Prenatal Screening for Fetal Aneuploidy in Singleton Pregnancies [J].

Chitayat, David ;

Langlois, Sylvie ;

Wilson, R. Douglas ;

Audibert, Francois ;

Blight, Claire ;

Brock, Jo-Ann ;

Cartier, Lola ;

Carroll, June ;

Desilets, Valerie A. ;

Gagnon, Alain ;

Johnson, Jo-Ann ;

Langlois, Sylvie ;

Murphy-Kaulbeck, Lynn ;

Okun, Nanette ;

Pastuck, Melanie ;

Senikas, Vyta ;

Langlois, Sylvie ;

Chitayat, David ;

DeBie, Isabelle ;

Demczuk, Suzanne ;

Desilets, Valerie A. ;

Geraghty, Michael T. ;

Marcadier, Janet ;

Nelson, Tanya N. ;

Skidmore, David ;

Siu, Vicky .

JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA, 2011, 33 (07) :736-750

[8] Effect of gestational age on first trimester maternal serum prenatal screening correction factors for ethnicity and IVF conception [J].

Cowans, Nicholas J. ;

Spencer, Kevin .

PRENATAL DIAGNOSIS, 2013, 33 (01) :56-60

[9] First-trimester serum marker distribution in singleton pregnancies conceived with assisted reproduction [J].

Engels, M. A. J. ;

Kooij, M. ;

Schats, R. ;

Twisk, J. W. R. ;

Blankenstein, M. A. ;

van Vugt, J. M. G. .

PRENATAL DIAGNOSIS, 2010, 30 (04) :372-377

[10] Prenatal diagnosis after ART success: The role of early combined screening tests in counselling pregnant patients [J].

Ghisoni, L ;

Ferrazzi, E ;

Castagna, C ;

Setti, PEL ;

Masini, AC ;

Pigni, A .

PLACENTA, 2003, 24 :S99-S103

← 1 2 3 4 →