Placental volume and other first-trimester outcomes: are there differences between fresh embryo transfer, frozen-thawed embryo transfer and natural conception?

Choux, Cécile; Ginod, Perrine; Barberet, Julie; Rousseau, Thierry; Bruno, Céline; Shrivastava, Paul; Astruc, K.; Fauque, Patricia

doi:10.1016/j.rbmo.2018.12.023

Cited by 23 publications

(16 citation statements)

References 92 publications

(108 reference statements)

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“…ART procedures, independent of infertility, induce cellular behavior in late gestation reflective of human placental pathologies associated with ART As noted in previous studies, the late gestational placenta overgrowth phenotype in mouse is relevant to human IVF placentas that also display overgrowth and increased thickness (Choux et al, 2019;Daniel et al, 1999;Haavaldsen et al, 2012;Joy et al, 2012;Zhang et al, 2011). Here, we demonstrate that embryo culture from the 1-cell to blastocyst stage results in the most dramatic increases in placental weight and differences in junctional zone cell composition, suggesting that the embryo culture procedure is the largest driver of placental overgrowth observed in humans.…”

Section: Discussionmentioning

confidence: 68%

“…Most assessments are limited to crown-rump length measurements, estimates of fetal and placental volume, and uterine artery pulsatility index, a measure of uteroplacental perfusion. Two groups found that first trimester placental volume is significantly reduced in fresh IVF cycles compared with natural conceptions (Choux et al, 2019;Rizzo et al, 2016). Another group found that a specific embryo culture medium is associated with lower birth weight and that fetal weight differences could be detected as early as the second trimester (Dumoulin et al, 2010;Nelissen et al, 2012;Nelissen et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

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Assisted reproductive technologies induce temporally specific placental defects and the preeclampsia risk marker sFLT1 in mouse

et al. 2020

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Although widely used, assisted reproductive technologies (ARTs) are associated with adverse perinatal outcomes. To elucidate their underlying causes, we have conducted a longitudinal analysis of placental development and fetal growth using a mouse model to investigate the effects of individual ART procedures: hormone stimulation, in vitro fertilization (IVF), embryo culture and embryo transfer. We demonstrate that transfer of blastocysts naturally conceived without hormone stimulation and developed in vivo prior to transfer can impair early placentation and fetal growth, but this effect normalizes by term. In contrast, embryos cultured in vitro before transfer do not exhibit this compensation but rather display placental overgrowth, reduced fetal weight, reduced placental DNA methylation and increased levels of sFLT1, an anti-angiogenic protein implicated in causing the maternal symptoms of preeclampsia in humans. Increases in sFLT1 observed in this study suggest that IVF procedures could increase the risk for preeclampsia. Moreover, our results indicate that embryo culture is the major factor contributing to most placental abnormalities and should therefore be targeted for optimization.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Assisted reproductive technologies induce temporally specific placental defects and the preeclampsia risk marker sFLT1 in mouse

et al. 2020

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“…The adverse perinatal and maternal outcomes associated with cryopreservation might be originated by supraphysiological steroid hormones levels during early trophoblast invasion, which lead to an anomalous placental development (Choux et al, 2019;Hiura et al, 2017;Lyall et al, 2013). The AC-FET might be less 'physiological' than a NC-FET cycle due to the preparation of the endometrium with hormonal replacement requiring medication (Groenewoud et al, 2013).…”

Section: Hdp Preeclampsia and Placental Diseasementioning

confidence: 99%

“…There might be asynchrony between the embryo and the endometrium in FET cycles that influence fetal growth and development resulting in increased birth weight (Berntsen et al, 2018;Pinborg et al, 2016). Two studies found that placentas after FET were larger than after fresh ET (Choux et al, 2019;Rizzo et al, 2016). Increased placental size has been suggested to be associated with fetal hyperglycemia and indirectly to fetal overgrowth (Acosta et al, 2015) and could explain the increased risk of LGA and macrosomia in FET offspring.…”

Section: Birthweightmentioning

confidence: 99%

Lower risk of adverse perinatal outcomes in natural versus artificial frozen–thawed embryo transfer cycles: a systematic review and meta-analysis

Moreno-Sepúlveda

Espinós

Checa

2021

Reproductive BioMedicine Online

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“…Less is known about the impact of IVF treatment with fresh or frozen-thawed ET on these features of first-trimester placental development. The only two studies that distinguished between pregnancies after fresh and frozen-thawed ET have demonstrated a larger first-trimester PV in pregnancies after frozen-thawed ET than in pregnancies after fresh ET ( Rizzo et al ., 2016 ; Choux et al ., 2019 ). However, both studies had a cross-sectional design and PV was obtained at the end of the first trimester.…”

Section: Introductionmentioning

confidence: 99%

The influence of frozen-thawed and fresh embryo transfer on utero-placental (vascular) development: the Rotterdam Periconception cohort

et al. 2021

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STUDY QUESTION Does frozen-thawed or fresh embryo transfer (ET) influence utero-placental (vascular) development, when studied using three-dimensional (3D) ultrasound and virtual reality imaging techniques? SUMMARY ANSWER In the first trimester, placental developmental parameters, that is, placental volume (PV) and utero-placental vascular volume (uPVV), were comparable between pregnancies resulting from frozen-thawed ET, fresh ET and natural conception; and in the second and the third trimester, uterine artery Doppler indices were lower in pregnancies after frozen-thawed ET compared to pregnancies after fresh ET and natural conception. WHAT IS KNOWN ALREADY Pregnancies after frozen-thawed ET are at risk of developing placenta-related pregnancy complications. There is strong evidence that impaired first-trimester spiral artery remodelling is involved in the pathophysiology of these complications. Studies on longitudinal placental development in pregnancies with different modes of conception, that is, after frozen-thawed ET, fresh ET or natural conception, are lacking. STUDY, DESIGN, SIZE, DURATION Women with singleton pregnancies were included before 10 weeks of gestation, between January 2017 and July 2018, as a subcohort of the ongoing Rotterdam Periconception cohort. Results were partially validated in 722 women from the total cohort, which was conducted from November 2010 onwards. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 214 women, of whom 32 conceived after frozen-thawed ET, 56 conceived after fresh ET and 126 conceived naturally, were selected. PV and uPVV measurements were obtained at 7, 9 and 11 weeks of gestation by transvaginal 3D (power Doppler) ultrasound. The uterine artery pulsatility index (UtA-PI) and resistance index (UtA-RI) were measured transvaginally at 7, 9, 11 and 13 weeks and abdominally at 22 and 32 weeks of gestation by pulsed wave Doppler ultrasound. In the validation cohort, the PV was measured in 722 women. Associations between mode of conception and placental development were studied using linear mixed models. MAIN RESULTS AND THE ROLE OF CHANCE First-trimester parameters of placental development, that is, PV, uPVV, UtA-PI and UtA-RI, were comparable between pregnancies after frozen-thawed and fresh ET and naturally conceived pregnancies. In our validation cohort, comparable results were found for PV. However, the second- and third-trimester UtA-PI and UtA-RI in pregnancies after frozen-thawed ET were significantly lower than in pregnancies after fresh ET (βUtA-PI −0.158 (95% CI: −0.268, −0.048), P = 0.005; βUtA-RI −0.052 (95% CI: −0.089, −0.015), P = 0.006). The second- and third-trimester uterine artery indices in pregnancies after fresh ET were comparable to those in pregnancies after natural conception. LIMITATIONS, REASONS FOR CAUTION The main limitation of this study is the lack of power to optimally detect differences in placental development and placenta-related pregnancy outcomes between pregnancies after different modes of conception. Moreover, our population was selected from a tertiary hospital and included a relatively limited number of pregnancies. Therefore, external validity of the results should be confirmed in a larger sample size. WIDER IMPLICATIONS OF THE FINDINGS These findings indicate no significant impact of conception mode on early placental development and a beneficial impact for frozen-thawed ET on the second- and third-trimester Doppler indices. This suggests that frozen-thawed ET may not be as detrimental for placental perfusion as previous research has demonstrated. As the number of clinics applying the ‘freeze-all strategy’ increases, future research should focus on establishing the optimal uterine environment, with regards to hormonal preparation, prior to ET to reduce placental-related pregnancy complications after frozen-thawed ET. STUDY FUNDING/COMPETING INTEREST(S) This research was funded by the Erasmus MC Medical Research Advisor Committee’s ‘Health Care Efficiency Research’ program and the department of Obstetrics and Gynaecology of the Erasmus MC, University Medical Center, Rotterdam, The Netherlands. JSEL reports grants and personal fees from Ferring, personal fees from Titus Healthcare, grants and personal fees from Ansh Labs, grants from NIH, grants from Dutch Heart Association and grants from ZonMW outside the submitted work. None of the other authors have a conflict of interest. TRIAL REGISTRATION NUMBER Registered at the Dutch Trial Register (NTR6684).

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Placental volume and other first-trimester outcomes: are there differences between fresh embryo transfer, frozen-thawed embryo transfer and natural conception?

Cited by 23 publications

References 92 publications

Assisted reproductive technologies induce temporally specific placental defects and the preeclampsia risk marker sFLT1 in mouse

Assisted reproductive technologies induce temporally specific placental defects and the preeclampsia risk marker sFLT1 in mouse

Lower risk of adverse perinatal outcomes in natural versus artificial frozen–thawed embryo transfer cycles: a systematic review and meta-analysis

The influence of frozen-thawed and fresh embryo transfer on utero-placental (vascular) development: the Rotterdam Periconception cohort

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