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.
Fertil Steril
; 100(5): 1314-20, 2013 Nov.
Article
em En
| MEDLINE
| ID: mdl-23891271
ABSTRACT
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 ßhCG 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 fßhCG 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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Proteína Plasmática A Associada à Gravidez
/
Diagnóstico Pré-Natal
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Síndrome de Down
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Técnicas de Reprodução Assistida
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Limite:
Female
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Humans
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Pregnancy
Idioma:
En
Revista:
Fertil Steril
Ano de publicação:
2013
Tipo de documento:
Article