Spontaneous and in vitro fertilization pregnancies have comparable first trimester screening profiles for Down syndrome

J Turk Ger Gynecol Assoc. 2019 May 28;20(2):97-105. doi: 10.4274/jtgga.galenos.2018.2017.0133. Epub 2018 Sep 11.


Objective: We aimed to compare the first trimester screening profiles of spontaneous (n=972) and in in vitro fertilization (IVF) pregnancies (n=339) in a population of patients who had uncomplicated singleton pregnancies comparable for maternal age, gestation, body mass index, and ethnicity.

Material and methods: A non-interventional analysis of retrospective cohort data and review of the literature.

Results: All IVF pregnancies were achieved via intracytoplasmic sperm injection using the same ovarian stimulation protocol with recombinant follicle-stimulating hormone and a gonadotropin-releasing hormone antagonist, cetrorelix acetate. The means of the multiple of median (MoM) of pregnancy-associated plasma protein-A (PAPP-A) were slightly lower in the fresh (1.19±0.6 vs 1.33±0.7, respectively; p=0.056) and frozen embryo transfer (1.03±0.5 vs 1.33±0.7, respectively; p=0.036) IVF pregnancies compared with natural conceptions. However, when the medians of the MoMs of PAPP-A and beta-human chorionic gonadotrophin (β-hCG), and their distributions were compared across the mode of conception, there were no differences between IVF pregnancies spontaneous pregnancies. Furthermore, the scatterplot diagram and curve fitting regression analyses revealed no difference in the temporal relations of β-hCG and PAPP-A with each other and gestational age between spontaneous and IVF pregnancies.

Conclusion: These results support the notion that uncomplicated singleton IVF pregnancies have similar first trimester screening profiles to spontaneous conceptions.

Keywords: First trimester screening; pregnancy; pregnancy-associated plasma protein-A; beta-human chorionic gonadotrophin; nuchal translucency; in vitro fertilization; intracytoplasmic sperm injection.