Peak Serum Estradiol Level During Controlled Ovarian Stimulation Is not Associated with Lower Levels of Pregnancy-Associated Plasma Protein-A or Small for Gestational Age Infants: A Cohort Study

Dunne, Caitlin; Cho, Kristy; Shan, Angel; Hutcheon, Jennifer A.; Durland, Ursula; Seethram, Ken; Havelock, Jon

doi:10.1016/j.jogc.2017.01.031

Cited by 14 publications

(12 citation statements)

References 37 publications

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“…This level was typically obtained on the day of hCG or GnRH analog trigger. High E 2 , defined as >90th percentile for the population, was 3,515 (pg/mL), which is consistent with prior published literature (6,11).…”

Section: Methodssupporting

confidence: 90%

“…Our findings reflect the discordance observed in the literature. In at least one other study, peak E 2 levels were not associated with adverse outcomes, including hypertensive disease, stillbirth, and SGA (6), whereas in another they were (11). The effects of controlled ovarian hyperstimulation are complex and are likely not completely captured by the effects of peak E 2 alone.…”

Section: Discussionmentioning

confidence: 96%

“…In particular, high levels of E 2 associated with controlled ovarian hyperstimulation have been reported to impede the normal development of spiral arteries, leading to placental insufficiency and alteration of angiogenesis (4,5). However, the literature has not universally supported the association of high E 2 with adverse pregnancy outcomes (6,7).…”

mentioning

confidence: 99%

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Risk of ischemic placental disease in fresh and frozen embryo transfer cycles

Johnson

Hacker

Resetkova

et al. 2019

Fertility and Sterility

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Objectives: To evaluate the association of fresh and frozen embryo transfer with the development of ischemic placental disease (IPD), hypothesizing that differences in implantation environment affect placentation and thus pregnancy outcomes. Design: We performed a secondary analysis of a retrospective cohort study of deliveries linked to IVF cycles. Setting: Tertiary hospital and infertility treatment center. Patient(s): We included all women who underwent an autologous IVF cycle and had a live-born infant or an intrauterine fetal demise (IUFD). We excluded women less than 18 years of age. Intervention(s): We compared pregnancies resulting from frozen embryo transfer (frozen) cycles with those resulting from fresh embryo transfer (fresh) cycles. Main Outcome Measure(s): The primary outcome was a composite outcome of IPD or IUFD due to placental insufficiency. Ischemic placental disease included pre-eclampsia, placental abruption, and small for gestational age (SGA). We calculated risk ratios (RRs) and 95% confidence intervals (CIs). Result(s): Compared with fresh cycles, frozen cycles had a lower risk of IPD or IUFD from placental insufficiency (RR 0.75, 95% CI 0.59-0.97). Frozen cycles also conferred a lower risk of SGA than fresh cycles (RR 0.58, 95% CI 0.41-0.81). Risks of pre-eclampsia (RR 1.3, 95% CI 0.84-1.9) and abruption (RR 1.2, 95% CI 0.56-2.4) were similar. Conclusion(s):There was a lower risk of IPD among frozen cycles compared with fresh cycles. This association was largely driven by lower risk of SGA among frozen cycles. (Fertil Steril Ò 2019;111:714-21. Ó2018 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

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Section: Methodssupporting

confidence: 90%

Section: Discussionmentioning

confidence: 96%

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Risk of ischemic placental disease in fresh and frozen embryo transfer cycles

Johnson

Hacker

Resetkova

et al. 2019

Fertility and Sterility

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“…Interestingly, one study showed no correlation between blastocyst morphology parameters and first trimester maternal serum PAPP-A levels in ongoing pregnancies, which were defined as pregnancies which progressed to at least beyond 13 weeks of gestation in that study [39]. There are data to suggest that peak E2 level on the day of trigger is not associated with low maternal serum PAPP-A levels in pregnancies that result from fresh ET [40] although another publication demonstrated lower maternal serum PAPP-A levels in IVF and ICSI pregnancies compared with non-IVF and ICSI pregnancies. Furthermore, in the latter study, a correlation was found between peak E2 level at triggering and low first trimester maternal serum PAPP-A in IVF pregnancies [41].…”

Section: Discussionmentioning

confidence: 86%

The expression of pregnancy-associated plasma protein-A (PAPP-A) in human blastocoel fluid–conditioned media: a proof of concept study

Kavoussi

Chen

Wininger

et al. 2022

J Assist Reprod Genet

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Purpose The aim of this study was to determine if pregnancy-associated plasma protein-A (PAPP-A), typically measured in maternal serum and a potential predictor of adverse maternal and fetal outcomes such as spontaneous miscarriage, pre-eclampsia, and stillbirth, is expressed in blastocoel fluid–conditioned media (BFCM) at the embryonic blastocyst stage. Design This is an in vitro study. Methods BFCM samples from trophectoderm-tested euploid blastocysts (n = 80) from in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) patients were analyzed for PAPP-A mRNA. BFCM was obtained from blastocyst stage embryos in 20 uL drops. Blastocysts underwent trophectoderm biopsy for preimplantation genetic testing for aneuploidy prior to blastocyst vitrification and BFCM collection for snap freezing. cfDNA was synthesized using BFCM collected from 80 individual euploid blastocysts. Next, real-time qPCR was performed to detect expression of PAPP-A with GAPDH for normalization of expression in each sample. Results PAPP-A mRNA was detected in 45 of 80 BFCM samples (56.3%), with varying levels of expression across samples. Conclusion Our study demonstrates the expression of PAPP-A in BFCM. To our knowledge, this is the first study to report detection of PAPP-A mRNA in BFCM. Further studies are required and underway to investigate a greater number of BFCM samples as well as the possible correlation of PAPP-A expression with pregnancy outcomes of transferred euploid blastocysts. If found to predict IVF and obstetric outcomes, PAPP-A may provide additional information along with embryonic euploidy for the selection of the optimal blastocyst for embryo transfer.

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“…Некоторые авторы предполагают, что при гормональной стимуляции во время протокола ЭКО уровень эстрадиола может быть повышен ввиду образования множества желтых тел, что в свою очередь снижает уровень РАРР-А [11], а следовательно, и имплантацию и потери беременности раннего срока [12,13]. Вместе с тем в других исследованиях эта теория опровергается [14].…”

Section: обсуждение / Discussionunclassified

First trimester prenatal screening in multiple pregnancies. Part II: serum proteins PAPP-A and β-hCG as markers of adverse pregnancy outcomes

Цибизова

Govorov

Первунина

et al. 2020

Akušerstvo, ginekologiâ i reprodukciâ

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Цель исследования: оценить способность биохимических маркеров сыворотки крови беременной-PAPP-A (англ. pregnancy-associated plasma protein-A, ассоциированный с беременностью протеин-А плазмы) и β-ХГЧ (свободная бета-субъединица хорионического гонадотропина человека), исследованных в I триместре (11 +0-13 +6) во время комбинированного пренатального скрининга, прогнозировать неблагоприятные перинатальные исходы многоплодной беременности, наступившей спонтанно и в результате экстракорпорального оплодотворения (ЭКО). Материалы и методы. В основную группу вошли 65 женщин, беременность у которых наступила в результате ЭКО; 56 женщин со спонтанно наступившей беременностью составили группу сравнения. Во всех случаях беременности были многоплодными и были известны их исходы. В I триместре измеряли уровни PAPP-A и β-ХГЧ в сыворотке крови. Результаты выражали в абсолютных значениях и в МоМ (англ. multiples of median-значение, кратное медиане).

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Peak Serum Estradiol Level During Controlled Ovarian Stimulation Is not Associated with Lower Levels of Pregnancy-Associated Plasma Protein-A or Small for Gestational Age Infants: A Cohort Study

Cited by 14 publications

References 37 publications

Risk of ischemic placental disease in fresh and frozen embryo transfer cycles

Risk of ischemic placental disease in fresh and frozen embryo transfer cycles

The expression of pregnancy-associated plasma protein-A (PAPP-A) in human blastocoel fluid–conditioned media: a proof of concept study

First trimester prenatal screening in multiple pregnancies. Part II: serum proteins PAPP-A and β-hCG as markers of adverse pregnancy outcomes

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