First trimester screening with free β-hCG, PAPP-A and nuchal translucency in pregnancies conceived with assisted reproduction
Article first published online: 25 JUL 2002
Copyright © 2002 John Wiley & Sons, Ltd.
Volume 22, Issue 8, pages 718–721, August 2002
How to Cite
Orlandi, F., Rossi, C., Allegra, A., Krantz, D., Hallahan, T., Orlandi, E. and Macri, J. (2002), First trimester screening with free β-hCG, PAPP-A and nuchal translucency in pregnancies conceived with assisted reproduction. Prenat. Diagn., 22: 718–721. doi: 10.1002/pd.390
- Issue published online: 25 JUL 2002
- Article first published online: 25 JUL 2002
- Manuscript Accepted: 20 MAR 2002
- Manuscript Revised: 11 MAR 2002
- Manuscript Received: 27 NOV 2001
- Down syndrome screening;
- free β-hCG;
To evaluate the effect of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) on free beta-human chorionic gonadotrophin (β-hCG), pregnancy-associated plasma protein A (PAPP-A) and nuchal translucency (NT).
First trimester maternal dried whole blood specimens from 74 singleton pregnancies (32 by IVF and 42 by ICSI) and 30 twin pregnancies (16 by IVF and 14 by ICSI) in which conception was achieved with assisted reproduction techniques were matched with five controls resulting in 370 singleton controls and 150 twin controls. NT was measured using the Fetal Medicine Foundation protocol. Free β-hCG, PAPP-A and NT levels were compared between the IVF and control groups and between the ICSI and control groups using the Mann-Whitney U test.
In singleton pregnancies, the only significant difference was a 21% (95% CI: −35%–−7%) reduction in PAPP-A in IVF cases. In twin pregnancies, the only significant difference was a 12% (95% CI: −34%–−3%) reduction in NT in IVF cases. In singleton pregnancies, the false-positive rate for Down syndrome screening was 1.4% and 1.9% greater for the IVF and ICSI groups, respectively, compared to controls for a general screening population.
Patients undergoing assisted reproduction techniques should be counseled about the possibility of increased false-positive rates. Larger studies are needed to confirm this observation and to develop appropriate adjustment factors to reduce false-positive rates. Copyright © 2002 John Wiley & Sons, Ltd.