Increased incidence of preeclampsia in women conceiving by intrauterine insemination with donor versus partner sperm for treatment of primary infertility

Smith, Graeme N.; Walker, Mark; Tessier, Julie L.; Millar, Kenneth

doi:10.1016/s0002-9378(97)70215-1

Cited by 106 publications

(56 citation statements)

References 19 publications

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“…(3) It has also been proposed that prolonged exposure and adaptation to antigenic factors on the spermatozoa or on the placenta (i.e., "desensitization") might have a protective effect. (4,5) An exaggerated maternal immune reaction may not only result in defective implantation but might also eliminate the implanting conceptus. (3) That is, preeclampsia and implantation disorders might share etiologic pathways, including those involving immunological functions.…”

Section: Introductionmentioning

confidence: 99%

“…For example, intracytoplasmatic sperm injection in couples where the number of sperm cells available during intercourse is negligible, (11) or intrauterine insemination with donor sperm, oocytes or embryos, (4,12,13) might increase the risk by triggering an immune reaction in women without prior desensitization. Unfortunately, early studies on this subject were based on relatively small series of patients without appropriate control for age and parity; they also failed to consider the higher prevalence of multiple gestations resulting from assisted reproduction, an important factor since multiple gestations themselves carry a higher risk of preeclampsia.…”

Section: Introductionmentioning

confidence: 99%

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Gestational hypertension in pregnancies supported by infertility treatments: role of infertility, treatments, and multiple gestations

Hernández–Dı́az

Werler

Mitchell

2007

Fertility and Sterility

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Objective-To investigate the association between infertility treatments and gestational hypertension and preeclampsia. Design-Retrospective observational cohort. Setting-General population, United States and Canada.Patients-5151 women with non-malformed infants participating in the Slone Epidemiology Center Birth Defects Study between 1998 and 2006.Interventions-Women were interviewed within six months after delivery about sociodemographic and medical factors, the onset of gestational hypertension and preeclampsia, and about infertility treatments.Main Outcome Measures-We estimated relative risks and 95% confidence intervals using unconditional logistic regression.Results-The incidence of gestational hypertension was 8.9% (423/4762) among women without infertility treatments, and 15.8% (55/349) among women undergoing infertility treatments. Compared to spontaneous pregnancies, the crude relative risk for gestational hypertension in pregnancies resulting from infertility treatments was 1.9 (95% confidence interval 1.4-2.6). Multivariate adjustment for parity and pre-pregnancy BMI resulted in a relative risk of 1.6 (1.1-2.1). Further adjustment for multiple pregnancies, or restriction of the analyses to singleton pregnancies, moved the relative risk to 1.3. Each specific infertility procedure or drug was associated with a similarly elevated risk, which disappeared after adjustment for multiple gestations. Results were similar for preeclampsia.Corresponding Author: Allen A. Mitchell, M.D., Slone Epidemiology Center, Boston University, 1010 Commonwealth Avenue, Boston, MA 02215, USA, Tel: (617) 734 6006, Fax: (617) 738 5119, e-mail: E-mail: amitchell@slone.bu.edu. Conflict of interest: None CAPSULE:The higher incidence of gestational hypertension and preeclampsia in pregnancies resulting from infertility treatments is largely explained by the higher frequency of multiple gestations.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusion-Pregnancies resulting from infertility treatments have a higher incidence of gestational hypertension and preeclampsia than spontaneous conceptions. This increased risk is largely explained by the higher frequency of multiple gestations. NIH Public Access

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Gestational hypertension in pregnancies supported by infertility treatments: role of infertility, treatments, and multiple gestations

Hernández–Dı́az

Werler

Mitchell

2007

Fertility and Sterility

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“…[17][18][19] In contrast, a reduced risk for PE is found in women smoking cigarettes throughout pregnancy. The reduction in risk is 33% compared to nonsmoking women.…”

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confidence: 98%

Carbon Monoxide Inhibits Hypoxia/Reoxygenation-Induced Apoptosis and Secondary Necrosis in Syncytiotrophoblast

Bainbridge

Belkacemi

Dickinson

et al. 2006

The American Journal of Pathology

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Pre-eclampsia , a hypertensive disorder of pregnancy , affects 5 to 7% of pregnancies. Oxidative stress-induced placental injury and subsequent release of placental debris into the maternal circulation are key pathogenic events in the progression of pre-eclampsia. Women who smoke cigarettes throughout pregnancy are 33% less likely to develop this disorder than nonsmoking women. We postulated that elevated carbon monoxide concentrations in serum of smoking women inhibits apoptosis and debris shedding of trophoblast cells exposed to ischemia-reperfusion injury because carbon monoxide has cytoprotective effects on endothelial and smooth muscle cells in culture. This may be responsible for the reduced risk of preeclampsia in smoking women. To assess the cytoprotective properties of carbon monoxide within placental tissue , carbon monoxide treatments were administered to in vitro hypoxia/reoxygenation-insulted villous explants cultured from term human placenta. Induction of apoptosis was assessed using molecular and morphological approaches. Placental villous explants treated with carbon monoxide demonstrated 60% less hypoxia/reoxygenation-induced apoptosis in the differentiated syncytiotrophoblast layer compared with untreated explants undergoing a similar insult. In addition , retention of intact syncytial membranes was observed in carbon monoxide-treated explants. These observations indicate that carbon monoxide has potent antiapoptotic properties within human placenta and may hold therapeutic potential in the treatment of pre

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“…However, if a woman changes sexual partners, the immunity conferred by multiparity is lost [35,36]. Repeated exposure to sperm from the same individual may also be a preventive factor in the development of preeclampsia [37], and artificial insemination increases the risk of this disorder [38]. Sibai and Dekker have reviewed immune maladaptations in women with preeclampsia [39,40].…”

Section: Immune Maladaptationmentioning

confidence: 99%

Preeclampsia: Theories and speculations

Livingston

Maxwell²

2003

Wien Klin Wochenschr

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Increased incidence of preeclampsia in women conceiving by intrauterine insemination with donor versus partner sperm for treatment of primary infertility

Cited by 106 publications

References 19 publications

Gestational hypertension in pregnancies supported by infertility treatments: role of infertility, treatments, and multiple gestations

Gestational hypertension in pregnancies supported by infertility treatments: role of infertility, treatments, and multiple gestations

Carbon Monoxide Inhibits Hypoxia/Reoxygenation-Induced Apoptosis and Secondary Necrosis in Syncytiotrophoblast

Preeclampsia: Theories and speculations

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