Fetal Cardiac Remodeling Is Affected by the Type of Embryo Transfer in Pregnancies Conceived by in vitro Fertilization: A Prospective Cohort Study

Abstract

<b><i>Objective:</i></b> Pregnancies conceived via intracytoplasmic sperm injection (ICSI) are associated with a higher risk of fetal cardiac remodeling. The aim of this study was to evaluate whether the type of embryo transfer may affect the magnitude of fetal cardiac remodeling in pregnancies conceived via ICSI. <b><i>Methods:</i></b> Prospective cross-sectional study including 212 pregnancies conceived by ICSI (111 with frozen and 101 with fresh embryos) and 120 spontaneously conceived gestations. All women underwent ultrasound biometric evaluation, Doppler, and echocardiographic assessment, including evaluation of left and right atrial areas and sphericity index (SI), at 20–24 weeks of gestation. The χ<sup>2</sup> and Kruskal-Wallis <i>H</i> tests were used to analyze the data. <b><i>Results:</i></b> There was no difference in maternal characteristics, gestational age at ultrasound, Doppler, and fetal weight among the study groups. In pregnancies conceived by ICSI, left and right atrial areas were higher (<i>p</i> < 0.0001) and SI was lower (<i>p</i> < 0.0001) compared to spontaneously conceived pregnancies. Left (<i>p</i> = 0.004) and right (<i>p</i> = 0.023) atrial areas and left (<i>p</i> = 0.036) and right (<i>p</i> = 0.002) SIs were more affected in ICSI pregnancies conceived by fresh embryos. <b><i>Conclusion:</i></b> The risk of fetal cardiac remodeling is higher in pregnancies conceived by ICSI and independent from fetal size and Doppler. The magnitude of these changes is affected by the type of ICSI technique and is higher in pregnancies conceived by fresh embryos.

The association between assisted reproductive technology and cardiac remodeling in fetuses and early infants: a prospective cohort study

“…Thus far, few researchers have studied cardiac changes in association with specific ART techniques. A previous study reported larger atria and globular ventricles in fetuses conceived by fresh ET compared to those by FET [22]. Most recently, Boutet et al [19] demonstrated larger atria, thicker myocardial walls, and more impaired systolic function in a fresh ET group when compared to an FET population.…”

Fetal cardiac function evaluation: A review

“…Pregnancies conceived by in vitro fertilization have been also reported to be associated with remodeling of ventricular and atrial shape and abnormal fetal cardiac function. Subgroup analysis comparing pregnancies conceived by the transfer or fresh or frozen embryo showed a significant lower right and left SI and higher atrial areas in fetuses conceived using fresh embryos 19 …”

Fetal neurosonography and infant neurobehavior following conception by assisted reproductive technology with fresh or frozen embryo transfer

“…The observed differences between our three study groups could have been triggered by their different intrauterine vasoactive and hormonal milieu 56 , 57 , 58 , 59 , 60 , 61 , but also by changes in cardiac function: brain and heart development take place simultaneously in utero and often share morphogenetic programs 62 . Fetuses conceived by ART show differences in growth and cardiac shape and function compared with SC fetuses, fresh ET being associated with fetal smallness 6 , 63 and cardiac remodeling and dysfunction 64 , 65 , and frozen ET with macrosomia 63 , hypertensive disorders of pregnancy 5 , 66 and milder cardiac changes 65 , 67 .…”