Multifoetal gestations mediate the effect of in vitro fertilisation (IVF) on ischaemic placental disease in autologous oocyte IVF more than donor oocyte IVF

Chen

2022

JCM

We conducted this retrospective cohort study aiming to compare the different pregnancy outcomes of endometrial preparation regimens on ischemic placental disease in a frozen embryo transfer cycle. The study included a total of 9351 women who had undergone therapy at our single tertiary hospital from January 2015 to July 2020. The women were divided into three groups depending on their endometrial regimens: natural cycle, stimulation cycle, hormone replacement therapy cycle. The data were analyzed after propensity score matching, then we used multiple linear regression to study the relationship between ischemic placental disease and endometrial regimens, adjusted by confounding factors including age, body mass index, and score of propensity score matching. We performed univariate logistic regression, as well as multivariate logistic regression for ischemic placental disease, small for gestational age infant, placental abruption. and pre-eclampsia, respectively, listing the odds ratio and p-values in the table. As a result, risk of ischemic placental disease and small for gestational age infant were detected as higher in stimulation cycles compared to natural cycles before or after adjustment. Hormone replacement therapy cycles conferred a higher risk of pre-eclampsia and preterm delivery compared to natural cycles. No difference was found between stimulation cycles and hormone replacement therapy cycles, regardless of whether they are adjusted or not. In summary, more pharmacological intervention in endometrial preparation was associated with a higher risk of ischemic placental disease related symptoms than natural cycles for endometrial preparation in women undergoing frozen embryo transfer. Our findings supported that minimizing pharmacological interventions during endometrial preparation when conditions permit has positive implications for improving pregnancy outcomes.

Section: Discussionmentioning

confidence: 99%

“…This association was largely due to the lower risk of placental insufficiency during the frozen embryo transfer cycle. Another study showed an increased risk of IPD after donating oocyte fertilization in vitro [ 14 , 15 ]. However, the effect of the protocol during endometrial preparation on IPD has not been reported.…”

Section: Introductionmentioning

confidence: 99%

Effects of Different Endometrial Preparation Regimens during IVF on Incidence of Ischemic Placental Disease for FET Cycles

Chen

2022

JCM

“…When compared against IVF conceived with autologous oocytes, pregnancies from OD have shown lower placental volumes at the first trimester (27), a different uterine perfusion profile across gestation (28,29), higher rates of villitis of unknown etiology (VUE) (30) and also an increased risk of preeclampsia (14,26) and placental related disease in the third trimester (14,17,(31)(32)(33).…”

Section: Donated Oocytes Perinatal Outcomes and Placental Dysfunctionmentioning

confidence: 99%

Pregnancies through oocyte donation. A mini review of pathways involved in placental dysfunction

Caradeux,

Fernández,

Ávila

et al. 2024

Front. Med.

Pregnancies resulting from assisted reproductive techniques (ART) are increasingly prevalent worldwide. While most pregnancies conceived through in-vitro fertilization (IVF) progress without complications, mounting evidence suggests that these pregnancies are at a heightened risk of adverse perinatal outcomes. Specifically, IVF pregnancies involving oocyte donation have garnered attention due to numerous reports indicating an elevated risk profile for pregnancy-related complications within this subgroup of patients. The precise mechanisms contributing to this increased risk of complications remain incompletely understood. Nonetheless, it is likely that they are mediated by an abnormal immune response at the fetal–maternal interface. Additionally, these outcomes may be influenced by baseline patient characteristics, such as the etiology of infertility, absence of corpus luteum, and variations in endometrial preparation protocols, among other factors. This review aims to succinctly summarize the most widely accepted mechanisms that potentially contribute to the onset of placental dysfunction in pregnancies conceived through oocyte donation.

“…Interestingly, some reports comparing pregnancies from oocyte donation with those conceived with autologous oocytes have shown in the former group lower placental volumes at the first trimester [17], a different uterine perfusion profile across gestation [24,25], and higher rates of preeclampsia [7] and villitis of unknown etiology [26]. Moreover, recent studies have shown an increased risk of placental pathology in the third trimester, especially among pregnancies after oocyte donation [7,12,[27][28][29]. Overall, these findings suggest mechanisms related to progressive placental dysfunction, rather than abnormal placentation.…”

Section: Introductionmentioning

confidence: 99%

Fetal Growth Velocity according to the Mode of Assisted Conception

Bull¹,

Ávila²,

Vargas³

et al. 2023

Fetal Diagn Ther

Introduction: Pregnancies conceived through assisted reproductive techniques (ARTs) are on the rise worldwide and have been associated with a higher risk of placental-related disease in the third trimester. Methods: A cohort was created of singleton pregnancies after assisted reproduction, admitted at our institution for delivery, between January 2020 and August 2022. Fetal growth velocity from the second trimester to delivery was compared against a gestational-age-matched group of pregnancies spontaneously conceived according to the origin of the selected oocyte (i.e., autologous vs. donated). Results: 125 singleton pregnancies conceived through ART were compared to 315 singleton spontaneous conceptions. Overall, after adjusting for possible confounders, multivariate analysis demonstrated that ART pregnancies had a significantly lower estimated fetal weight (EFW) z-velocity from the second trimester to delivery (adjusted mean difference = −0.002; p = 0.035) and a higher frequency of EFW z-velocity in the lowest decile (adjusted OR = 2.32 [95% CI, 1.15–4.68]). Also, when ART pregnancies were compared according to the type of oocyte, those conceived with donated oocytes showed a significantly lower EFW z-velocity from the second trimester to delivery (adjusted mean difference = −0.008; p = 0.001) and a higher frequency of EFW z-velocity in the lowest decile (adjusted OR = 5.33 [95% CI, 1.34–21.5]). Conclusions: Pregnancies achieved through ART exhibit a pattern of lower growth velocity across the third trimester, especially those conceived with donated oocytes. The former represents a sub-group at the highest risk of placental dysfunction that may warrant closer follow-up.