The effects of transfer day in intracytoplasmic sperm injection (ICSI) pregnancies on first trimester screening test results

Year 2018, Volume: 4 Issue: 3, 1083 - 1093, 15.12.2018

Nur Dokuzeylül Güngör , Tuğba Gürbüz , Aynur Erşahin

https://doi.org/10.30569/adiyamansaglik.440359

Cited By: 1

Abstract

Objects: To compare first trimesterscrening (FTS) serum markers free
β-human chorionic gonodotropin (free β-hCG and pregnancy associated plasma
protein A (PAPP-A)  of blastocyst versus
cleavage stage embryo transfers after assisted
reproductive technologies (ART).

Methods: Retrospective
examinations of 123 women who conceived with ART were subjected to FTS from
January 2017 to December 2017 at Bahçeşehir University Göztepe Medical Park
Hospital In Vitro Fertilization (IVF) Unit.The age,gestational week,ultrasound
(US) markers and biochemistry markers(PAPP-A,free β-hCG) were
collected.Outcomes were regarded as meaningful when the p < 0.05.
Statistical Package For Social Sciences (SPSS) v.17.0 for Windows was preferred
to make statistical analysis.

Results: PAPP-A
amounts were remarkably low in day-3 (cleavage stage embryos) transfer
intracytoplasmic sperm injection (ICSI) pregnancies compared to day-5
(blastocyst stage embryos) transfer ICSI pregnancies.Free β-hCG amounts weren’t
significantly different in two groups (p=0.371). NT was unaffected by the
transferenceday (p=0.21). Also CRL wasunaffected by the transferenceday
(p=0.693). No differences appeared between 3rd and 5th day embryo transference
according to maternal age (p=0.616), weight (p=0.693) and gestational age
(p=0.742) at sampling.

Conclusion: Today,
the datas about the effects of ART over the ingredients of combined FTS for
chromosomal analysis are contentious yet.Day-3 ICSI pregnancies had
meaningfully low PAPP-A amounts which support the requirement to properly set
the combined FTS risks algoritm. These outcomes are likely to be because of
changings in the placenta of ART pregnancies.

Keywords

Assisted reproduction techniques, blastocyst, cleavage, first trimester screening

The effects of transfer day in intracytoplasmic sperm injection (ICSI) pregnancies on first trimester screening test results

Abstract

Objects

To
compare first trimester screning serum markers free β-human chorionic
gonodotropin (free β-hCG and pregnancy associated plasma protein A (PAPP-A)  of blastocyst versus cleavage stage embryo
transfers after assisted reproductive technologies (ART) .

Methods

Retrospective
analysis of 123 women who conceived with ART
undergone first-trimester  screening between
January 2017 and December 2017 at Bahçeşehir University Göztepe Medical Park Hospital  IVF Unit. The age, gestational week, ultrasound
markers and biochemistry  markers (PAPP- A,free
β-hCG) were collected. Results were considered significant when the p value was
less than 0.05. Statistical Package For Social Sciences (SPSS) version 17.0 for
Windows was used for statistical analysis.

Results

PAPP-A
levels were significantly lower in day-3 (cleavage stage embryos) transfer intracytoplasmic sperm injection (ICSI) pregnancies
compared to day-5 (blastocyst stage embryos) transfer ICSI pregnancies (p<0.05).
Free β-hCG levels weren’t significantly differ in two groups (p=0.371). NT was
unaffected by the day of transfer (p=0.21). Also CRL wasn’t affected by the day
of transfer (p=0.693). No differences appeared between day-3 and day-5 embryo
transfer with respect to maternal age ,(p=0.616) weight (p=0.693) and gestational
age (p=0.742)  at sampling.

 

Conclusion

Today,
the data on the effect of ART on the components of first trimester combined
screening

for
chromosomal analysis are still controversial. Day-3  ICSI  pregnancies 
had significantly

lower
PAPP-A levels supporting the need to appropriately adjust the combined first trimester

screening
(cFTS) risk algoritm. These results may be due to alterations in the
placentation of ART pregnancies.

Keywords

Assisted reproduction techniques, blastocyst, cleavage, first trimester screening

References

• 1.Mangalraj AM, Muthukumar K, Aleyamma T, Kamath MS, George K. Blastocyst stage transfer vs cleavage stage embryo transfer. J Hum Reprod Sci 2009;2:23–6.
• 2.Karaki RZ, Samarraie SS, Younis NA, Lahloub TM, Ibrahim MH. Blastocyst culture andtransfer: a step toward improved in vitro fertilization outcome. Fertil Steril 2002;77:114-18.
• 3.Edwards RG, Beard HK. Blastocyst stage transfer: pitfalls and benefits. Hum Reprod. 1999;14:1–4.
• 4.Gardner DK, Lane M. Culture and selection of viable blastocysts: a feasible proposition for human IVF? Hum Reprod Update. 1997;3:367–82.
• 5.Pool TB, Atiee SR, Martin JE. Oocyte and embryo culture: basic concepts and recent advances. Infert Reprod Med Clinics N Amer. 1998;9:181–203.
• 6.Tsirigotis M. Blastocyst stage transfer: pitfalls and benefits. Too soon to abandon current practice? Hum Reprod. 1998;13:3285–89.
• 7.Gardner DK, Schoolcraft WB. No longer neglected: the human blastocyst. Hum Reprod. 1998;13:3289–92.
• 8.Gardner DK, Balaban B. Choosing between day 3 and day 5 embryo transfers. Clin Obstet Gynecol. 2006;49:85–92.
• 9.Nicolaides KH. Screening for chromosomal defects. Ultrasound Obstet Gynecol. 2003;21:313–21.
• 10.Royal Australian and New Zealand College of Obstetricians and Gynaecologists and Human Genetics Society of Australasia. Prenatal screening tests for trisomy 21 (Down syndrome), trisomy18 (Edwards syndrome) and neural tube defects. Victoria: RoyalAustralian and New Zealand College of Obstetricians andGynaecologists; 2007.
• 11.Nicolaides KH. A model for a new pyramid of prenatal care based on the 11 to 13 weeks' assessment. Prenat Diagn 2011; 31: 3-6.
• 12.Sonek J, Nicolaides KH. Additional first-trimester ultrasound markers. Clin Lab Med 2010; 30: 573-92.
• 13.Kagan KO, Wright D, Spencer K et al. First-trimester screening for trisomy 21 by free beta-human chorionic gonadotropin and pregnancy-associated plasma protein-A: impact of maternal and pregnancy characteristics. Ultrasound Obstet Gynecol 2008; 31: 493-502.
• 14.Chitayat DS, Langlois S, Wilson RD. Prenatal screening for fetal aneuploidy in singleton pregnancies. J Obstet Gynaecol Can 2011;33:736-50.
• 15.Spencer K, Staboulidou I, Nicolaides KH. First trimester aneuploidy screening in the presence of a vanishing twin: implications for maternal serum markers. Prenat Diagn 2010; 30: 235-40.
• 16.Klemetti R, Gissler M, Hemminki E. Comparison of perinatal health of children born from IVF in Finland in the early and late 1990s. Hum Reprod. 2002;17(8):2192–8.
• 17.Wright VC, Chang J, Jeng G, Macaluso M. Centers for disease C, prevention. Assisted reproductive technology surveillance—United States, 2005. MMWR Surveill Summ. 2008;57(5):1–23.
• 18.Chen H, Egan JO, Ohlu JF. Regulation and activities of alpha-fetoprotein, Crit Rev Eukaryot Gene Expr 1997; 7: 11-41.
• 19.Frendo JL, Vidaud M, Guibourdenche J, Luton D, Muller F, Bellet D, et al. Defect of villous cytotrophoblast differentiation into syncytiotrophoblast in Down's syndrome, J Clin Endocrinol Metab 2000; 85: 3700-07.
• 20.Krantz DA, Larsen JW, Buchanan PD, Macri JN. First-trimester Down syndrome screening: free beta-human chorionic gonadotropin and pregnancy-associated plasma protein A, Am J Obstet Gynecol 1996;174: 612-16.
• 21.Spencer K. Evaluation of an assay of the free beta-subunit of choriogonadotropin andits potential value in screening for Down's syndrome. Clin Chem 1991;37:809-14.
• 22.Almog B, Al-Shalaty J, Sheizaf B, Shehata F, Son WY, Tan SL, et al. Difference between serum beta-human chorionic gonadotropin levels in pregnancies after in vitro maturation and in vitro fertilization treatments. Fertil Steril 2011; 95: 85-8.
• 23.Cole LA. Immunoassay of human gonadotropin, its free subunits, and metabolites, Clin Chem 1997;43:2233-43.
• 24.Spencer K. Second-trimester prenatal screening for Down syndrome and the relationship of maternal serum biochemical markers to pregnancy complications with adverse outcome, Prenat Diagn 2000;20:652-56.
• 25.Dugoff L, Hobbins JC, Malone FD, Vidaver J, Sullivan L, Canick JA, et al. Quad screen as a predictor of adverse pregnancy outcome. Obstet Gynecol 2005;106:260-67.
• 26.Spencer K, Crossley JA, Aitken DA, Nix AB, Dunstan FD, Williams K. The effect of temporal variation in biochemical markers of trisomy 21 across the first and second trimesters of pregnancy on the estimation of individual patient-specific risks and detection rates for Down's syndrome. Ann Clin Biochem 2003;40:219-31.
• 27.Zegers-Hochschild F, Altieri E, Fabres C, Fernandez E, Mackenna A, Orihuela P. Predictive value of human chorionic gonadotrophin in the outcome of early pregnancy after in-vitro fertilization and spontaneous conception. Hum Reprod 1994; 9:1550-55.
• 28.Barkai G, Goldman B, Ries L, Chaki R, Dor J, Cuckle H. Down's syndrome screening marker levels following assisted reproduction Prenat Diagn 1996;16: 1111-14.
• 29.Wald NJ, White N, Morris JK, Huttly WJ, Canick JA. Serum markers for Down's syndrome in women who have had in vitro fertilisation: implications for antenatal screening. Br J Obstet Gynaecol 1999;106:1304-06.
• 30.Bar-Hava I, Yitzhak M, Krissi H, Shohat M, Shalev J, Czitron B, et al. Triple-test screening in in vitro fertilization pregnancies. J Assist Reprod Genet 2001;18:226-9.
• 31.Giudice LC, Conover CA, Bale L, Faessen GH, Ilg K, Sun I, et al. Identification and regulation of the IGFBP-4 protease and its physiological inhibitor in human trophoblasts and endometrial stroma: evidence for paracrine regulation of IGF-II bioavailability in the placental bed during human implantation. J Clin Endocrinol Metab 2002;87:2359-66.
• 32.Santolaya-Forgas J, De Leon JA, Cullen HR, Castracane VD, Kauffman RP, Sifuentes GA. Low pregnancy-associated plasma protein-a at 10 (+1) to 14(+6) weeks of gestation and a possible mechanism leading to miscarriage. Fetal Diagn Ther 2004;19: 456-61.
• 33.Shih W, Rushford DD, Bourne H, Garrett C, McBain JC, Healy DL, et al. Factors affecting low birthweight after assisted reproduction technology: difference between transfer of fresh and cryopreserved embryos suggests an adverse effect of oocyte collection. Hum Reprod 2008;23: 1644-53.
• 34.Pinborg A, Loft A, Aaris Henningsen AK, Rasmussen S, Andersen AN. Infant outcome of 957 singletons born after frozen embryo replacement: the Danish National Cohort Study 1995–2006. Fertil Steril 2010;94:1320-27.
• 35.Dumoulin JC, Land JA, Van Montfoort AP, Nelissen EC, Coonen E, Derhaag JG, et al. Effect of in vitro culture of human embryos on birthweight of newborns. Hum Reprod 2010;25:605-12.
• 36.Ranta JK, Raatikainen K, Romppanen J, Pulkki K, Heinonen S. Increased time-to-pregnancy and first trimester Down's syndrome screening. Hum Reprod 2010;25:412–7.
• 37.Amor DJ, Xu JX, Halliday JL, Francis I, Healy DL, Breheny S, et al. 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. Hum Reprod 2009;24:1330–8.
• 38.Anderson UD, Olsson MG, Kristensen KH, Akerstr€om B, Hansson SR.Review: biochemical markers to predict preeclampsia. Placenta 2012;33:42–7.
• 39.Talaulikar VS, Arulkumaran S. Reproductive outcomes after assisted conception.Obstet Gynecol Sury 2012;67:566–83.
• 40.Bender F, Hecken J, Reinsberg J, Berg C, Van der Ven H, Gembruch U, et al. Altered first-trimester screening markers after IVF/ICSI: no relationship withsmall-for-gestational-age and number of embryos transferred. Reprod BiomedOnline 2010;20:516–22.