Mid‐gestation Down syndrome screening test and pregnancy outcome among unstimulated assisted‐conception pregnancies

Shulman, Adrian; Maymon, Ron

doi:10.1002/pd.650

Cited by 17 publications

(3 citation statements)

References 16 publications

(27 reference statements)

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“…Furthermore, our study was limited in classification of fresh versus frozen transfer of embryos. Prior studies have shown that frozen embryo transfer results in elevated AFP and/or hCG levels (Shulman and Maymon, 2003;Hui et al, 2003), consistent with findings in our ED group. A large group with a number of EDs performed without freezing before embryo transfer would need to be studied to separate the effects of donation from the effects of frozen storage on serum marker levels.…”

Section: Discussionsupporting

confidence: 92%

“…The effects of IUI on Down syndrome screening markers have not been well studied, although it seems that the second-trimester marker patterns are similar to those in IVF pregnancies, with decreased AFP (Hsu et al, 1999) and uE3, and increased beta-hCG (Barkai et al, 1996), while the first-trimester markers are unaffected (Liao et al, 2001;Wojdemann et al, 2001). Pregnancies achieved with ED are reported to have increased AFP and hCG (Barkai et al, 1996;Maymon and Shulman, 2001;Hui et al, 2003;Shulman and Maymon, 2003), but the levels of other markers have not been examined.…”

Section: Introductionmentioning

confidence: 99%

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First- and Second-Trimester Down Syndrome Screening Markers in Pregnancies Achieved Through Assisted Reproductive Technologies (ART): A FASTER Trial Study

Lambert‐Messerlian

Dugoff

Vidaver

et al. 2006

Obstetrical & Gynecological Survey

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ObjectiveTo determine whether first-and second-trimester Down syndrome screening markers and screenpositive rates are altered in pregnancies conceived using assisted reproductive technologies (ARTs).Methods ART pregnancies in the multicenter FASTER trial were identified. Marker levels were evaluated for five types of ART: in vitro fertilization with ovulation induction (IVF-OI), IVF with OI and egg donation (IVF-OI-ED), IVF with ED (IVF-ED), and intrauterine insemination with OI (IUI-OI) or without OI (IUI). Each group was compared to non-ART controls using Mann-Whitney U analysis. ResultsFirst-trimester marker levels were not significantly different between ART and control pregnancies, with the exception of reduced PAPP-A levels in the IUI-OI group. In contrast, second-trimester inhibin A levels were increased in all ART pregnancies, estriol was reduced and human chorionic gonadotropin (hCG) was increased in IVF and IUI pregnancies without ED, and alpha-fetoprotein (AFP) was increased in ED pregnancies. Second-trimester screen-positive rates were significantly higher than expected for ART pregnancies, except when ED was used.Conclusions These data show that ART significantly impacts second-, but not first-, trimester markers and screen-positive rates. The type of adjustment needed in second-trimester screening depends on the particular type of ART used.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

First- and Second-Trimester Down Syndrome Screening Markers in Pregnancies Achieved Through Assisted Reproductive Technologies (ART): A FASTER Trial Study

Lambert‐Messerlian

Dugoff

Vidaver

et al. 2006

Obstetrical & Gynecological Survey

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“…Several studies have shown such association with intrauterine growth retardation [1] , maternal hypertension [2,3] , fetal malformations, chromosomal aberrations [4] , and adverse perinatal outcome [5] . The poor outcome was reported in infertility patients [6] and during the first trimester [7] . The purpose of the current study was to analyze the characteristics of a group of pregnancies with extreme elevation of MShCG.…”

Section: Introductionmentioning

confidence: 99%

Adverse Outcome of Pregnancies with Extremely High Levels of Maternal Serum Human Chorionic Gonadotropin

Sharony

Itzhaky²,

Amiel³

et al. 2008

Fetal Diagn Ther

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Background: The associated risk of elevated levels of maternal serum human chorionic gonadotropin (MShCG) with pregnancy complications was reported in many studies. However, the outcome of pregnancies with extremely high levels of MShCG was never independently studied. Methods: We report on 6 out of 45,990 studied patients with extremely high levels of MShCG (>15 multiples of the medians) analyzed during the second trimester. Results: Although our patient population was composed of more Jewish than Arab pregnant women, all those patients were Arabs. Overall, the prognosis of those pregnancies was poor. In 1 case, an antepartum fetal death occurred, 2 had premature deliveries (one of the newborns had severe failure to thrive), and 2 delivered small for gestational age babies. In 5 of these 6 cases, no specific diagnosis was established. One case was complete hydatidiform mole with a coexisting normal fetus. Conclusions: We recommend that these patients undergo counseling in which the predicted outcome will be described. In addition, a follow-up of high-risk pregnancy should be implemented: sonographic evaluation should be performed, initially to rule out a molar gestation. The patients should then be followed for growth restriction and they should be monitored to rule out other pregnancy complications such as premature labor and antepartum fetal death. Finally, the overrepresentation of Arabs among our affected patients raises the question of a possible genetic tendency for increased MShCG levels especially in the extreme level group.

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Second trimester serum tests for Down's Syndrome screening

Alldred

Deeks

Guo

et al. 2012

Cochrane Database of Systematic Reviews

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Background Down's syndrome occurs when a person has three copies of chromosome 21-or the specific area of chromosome 21 implicated in causing Down's syndrome-rather than two. It is the commonest congenital cause of mental retardation. Noninvasive screening based on biochemical analysis of maternal serum or urine, or fetal ultrasound measurements, allows estimates of the risk of a pregnancy being a ected and provides information to guide decisions about definitive testing. Objectives To estimate and compare the accuracy of second trimester serum markers for the detection of Down's syndrome.

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Mid‐gestation Down syndrome screening test and pregnancy outcome among unstimulated assisted‐conception pregnancies

Abstract: OD embryos are a unique clinical model for evaluating the uterine compartment and its contribution to mid-gestation serum marker secretion.

Cited by 17 publications

References 16 publications

First- and Second-Trimester Down Syndrome Screening Markers in Pregnancies Achieved Through Assisted Reproductive Technologies (ART): A FASTER Trial Study

First- and Second-Trimester Down Syndrome Screening Markers in Pregnancies Achieved Through Assisted Reproductive Technologies (ART): A FASTER Trial Study

Adverse Outcome of Pregnancies with Extremely High Levels of Maternal Serum Human Chorionic Gonadotropin

Second trimester serum tests for Down's Syndrome screening

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