Are There Differences in Placental Volume and Uterine Artery Doppler in Pregnancies Resulting From the Transfer of Fresh Versus Frozen-Thawed Embryos Through In Vitro Fertilization

Abstract

Objective:

To compare uterine artery pulsatility index (PI) and 3-dimensional (3D) placental volume values in first-trimester pregnancies conceived naturally or through in vitro fertilization (IVF) technique using either fresh or cryopreserved embryo and to relate these measurements with preeclampsia (PE) development.

Methods:

Uterine artery PI and placental volume were measured at 11 + 0 to 13 + 6 weeks of gestation in 266 IVF pregnancies (139 women with fresh embryo and 127 women with frozen-thawed embryo transfer) and in 266 spontaneously conceived pregnancies matched for maternal age. Nulliparous women with singleton pregnancies were recruited. The mean, highest, and lowest uterine artery PI and placental volume values measured were converted to multiples of the expected normal median (MoM) adjusted for gestational age. The MoM values of IVF pregnancies were compared with those of the naturally conceived group and related to PE development.

Results:

No differences were found in uterine artery PI MoM between the 3 groups. Placental volume was significantly lower than in both IVF groups when compared to the controls (fresh embryo IVF Z = 9.33; P ≤ .0001; frozen-thawed embryos IVF Z = 3.1; P = .04). The IVF pregnancies with fresh embryos showed placental volume MoM values significantly lower than in the frozen-thawed embryo IVF pregnancies (U = 5.4; P ≤ .0001). In fresh embryo IVF pregnancies developing PE placental volume values resulted lower than in the normotensive ones (U = 2.11; P = .03), while no differences were found for uterine artery PI values.

Conclusion:

First-trimester placental volume, as assessed by 3D ultrasound, is reduced in IVF pregnancies, and these differences are more marked in those obtained with fresh embryos than those obtained with cryopreservation. This may explain the better obstetrical and perinatal outcomes occurring with the former technique.

Keywords

placental volume uterine artery Doppler first trimester IVF embryo cryopreservation preeclampsia

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References

Helmerhorst

Perquin

Donker

Keirse

. Perinatal outcome of singletons and twins after assisted conception: a systematic review of controlled studies. BMJ. 2004;328(7434):261.

Jackson

Gibson

Croughan

. Perinatal outcomes in singletons following in vitro fertilization: a meta- analysis. Obstet Gynecol. 2004;103(3):551–563.

McDonald

Han

Mulla

Murphy

Beyene

Ohlsson

, on behalf of the Knowledge Synthesis Group. Preterm birth and low birth weight among in vitro fertilization singletons: a systematic review and meta-analyses. Eur J Obstet Gynecol Reprod Biol. 2009;146(2):138–148.

Maheshwari

Pandey

Shetty

Hamilton

Bhattacharya

. Obstetric and perinatal outcomes in singleton pregnancies resulting from the transfer of frozen thawed versus fresh embryos generated through in vitro fertilization treatment: a systematic review and meta-analysis. Fertil Steril. 2012;98(2):368–377.

Shapiro

Daneshmand

Garner

Aguirre

Hudson

Thomas

. Evidence of impaired endometrial receptivity after ovarian stimulation for in vitro fertilization: a prospective randomized trial comparing fresh and frozen-thawed embryo transfer in normal responders. Fertil Steril. 2011;96(2):344–348.

Papanikolaou

Bourgain

Kolibianakis

Tournaye

Devroey

. Steroid receptor expression in late follicular phase endometrium in GnRH antagonist IVF cycles is already altered, indicating initiation of early luteal phase transformation in the absence of secretory changes. Hum Reprod. 2005;20(6):1541–1547.

Horcajadas

Dıaz-Gimeno

Pellicer

Simon

. Uterine receptivity and the ramifications of ovarian stimulation on endometrial function. Semin Reprod Med. 2007;25(6):454–460.

Bourgain

Devroey

. The endometrium in stimulated cycles for Ivf. Hum Reprod Update. 2003;9(6):515–522.

Rizzo

Aiello

Pietrolucci

Arduini

. Placental volume and uterine artery doppler evaluation at 11 + 0 to 13 + 6 weeks of gestation in pregnancies conceived with in vitro fertilization: comparison between autologous and donor oocyte recipients. Ultrasound Obstet Gynecol. 2016;47(6):726–731.

10.

Kansal Kalra

Ratcliffe

Milman

Gracia

Coutifaris

Barnhart

. Perinatal morbidity after in vitro fertilization is lower with frozen embryo transfer. Fertil Steril. 2011;95(2):548–553.

11.

Plasencia

Maiz

Bonino

Kaihura

Nicolaides

. Uterine artery Doppler at 11 + 0 to 13 + 6 weeks in the prediction of pre-eclampsia. Ultrasound Obstet Gynecol. 2007;30(5): 742–749.

12.

Schuchter

Metzenbauer

Hafner

Philipp

. Uterine artery Doppler and placental volume in the first trimester in the prediction of pregnancy complications. Ultrasound Obstet Gynecol. 2001;18(6):590–592.

13.

Odibo

Goetzinger

Huster

Christiansen

Odibo

Tuuli

. Placental volume and vascular flow assessed by 3D power Doppler and adverse pregnancy outcomes. Placenta. 2011;32(3):230–234.

14.

Brown

Lindheimer

de Swiet

Van Assche

Moutquin

. The classification and diagnosis of the hypertensive disorders of pregnancy: statement from the international society for the study of hypertension in pregnancy (ISSHP). Hypertens Pregnancy. 2001;20(1):IX–XIV.

15.

Bertino

Spada

Occhi

. Neonatal anthropometric charts: the Italian neonatal study compared with other European studies. J Pediatr Gastroenterol Nutr. 2010;51(3):353–361.

16.

Rizzo

Capponi

Cavicchioni

Vendola

Arduini

. First trimester uterine Doppler and three-dimensional ultrasound placental volume calculation in predicting pre-eclampsia. Eur J Obstet Gynecol Reprod Biol. 2008;138(2):147–151.

17.

Wegrzyn

Faro

Falcon

Peralta

CFA

Nicolaides

. Placental volume measured by three-dimensional ultrasound at 11 to 13 + 6 weeks of gestation: relation to chromosomal defects. Ultrasound Obstet Gynecol. 2005;26(1):28–32.

18.

Rizzo

Capponi

Pietrolucci

Arduini

. Effects of maternal cigarette smoking on placental volume and vascularization measured by 3-dimensional power Doppler ultrasonography at 11+0 to 13+6 weeks of gestation. Am J Obstet Gynecol. 2009;200(4):415. e1–e5.

19.

Brosens

Pijnenborg

Vercruysse

Romero

. The ‘Great Obstetrical Syndromes’ are associated with disorders of deep placentation. Am J Obstet Gynecol. 2011;204(3):193–201.

20.

Khalil

Cowans

Spencer

Goichman

Meiri

Harrington

. First-trimester markers for the prediction of pre- eclampsia in women with a-priori high risk. Ultrasound Obstet Gynecol. 2010;35(6):671–679.

21.

Velauthar

Plana

Kalidindi

. First-trimester uterine artery Doppler and adverse pregnancy outcome: a meta-analysis involving 55 974 women. Ultrasound Obstet Gynecol. 2014;43(5):500–507.

22.

Prefumo

Fratelli

Soares

Thilaganathan

. Uterine artery Doppler velocimetry at 11–14 weeks in singleton pregnancies conceived by assisted reproductive technology. Ultrasound Obstet Gynecol. 2007;29(2):141–145.

23.

Carbone

Cruz

Sarquis

Akolekar

Nicolaides

. Assisted conception and placental perfusion assessed by uterine artery Doppler at 11–13 weeks’ gestation. Hum Reprod. 2011;26(7):1659–1664.

24.

Haapsamo

Martikainen

Tinkanen

Heinonen

Nuojua-Huttunen

Räsänen

. Low-dose aspirin therapy and hypertensive pregnancy complications in unselected IVF and ICSI patients: a randomized, placebo-controlled, double-blind study. Hum Reprod. 2010;25(12):2972–2977.

25.

Hafner

Metzenbauer

Höfinger

. Comparison between three-dimensional placental volume at 12 weeks and uterine artery impedance/notching at 22 weeks in screening for pregnancy-induced hypertension, pre-eclampsia and fetal growth restriction in a low-risk population. Ultrasound Obstet Gynecol. 2006;27:652–657.

26.

Choux

Carmignac

Bruno

Sagot

Vaiman

Fauque

. The placenta: phenotypic and epigenetic modifications induced by Assisted Reproductive Technologies throughout pregnancy. Clin Epigenetics. 2015;7(1):87.

27.

Hafner

Metzenbauer

Höfinger

. Placental growth from the first to the second trimester of pregnancy in SGA-foetuses and pre-eclamptic pregnancies compared to normal fetuses. Placenta. 2003:24(4):336–342.

28.

Wright

Akolekar

Syngelaki

Poon

Nicolaides

. A competing risks model in early screening for preeclampsia. Fetal Diagn Ther. 2012;32(3):171–178.