Bellver José, Lara Coral, Soares Sergio R, Ramírez Alberto, Pellicer Antonio, Remohí José, Serra Vicente
Unidad de Medicina Materno-Fetal and Unidad de Reproducción, Instituto Universitario IVI, Universidad de Valencia, Spain.
Hum Reprod. 2005 Sep;20(9):2623-7. doi: 10.1093/humrep/dei107. Epub 2005 May 19.
Serum biochemical markers [free betahCG (fbetahCG); pregnancy-associated plasma protein-A (PAPP-A)] used in first trimester Down's syndrome screening have not been fully investigated in pregnancies achieved by assisted reproduction techniques. We present data on pregnancies conceived by all types of assisted reproduction techniques, including pregnancies following ovum donation (OD) and a large sample by ICSI.
First trimester Down's syndrome screening was performed in 1054 normal singleton pregnancies: natural conception (n = 498), ovulation induction (OS, n = 97), IVF (n = 47), ICSI (n = 222) and OD (n = 190).
No differences in maternal levels of fbetahCG and PAPP-A, measured by the Kryptor system, appeared between naturally conceived pregnancies (n = 498) and those obtained with assisted reproduction techniques (n = 556). Several differences were apparent when comparing fbetahCG levels between different technologies but PAPP-A levels only differed between OS and IVF pregnancies (P < 0.05). In a further small study, no differences were observed using frozen embryos (n = 37), preimplantation genetic diagnosis (n = 53) or sperm from testicular biopsy (n = 21).
Data accumulated so far suggest that first trimester biochemical markers either do not need any adjustments (e.g. in pregnancies obtained after OS and ICSI), or have very little impact (e.g. IVF pregnancies) or no impact (e.g. OD pregnancies) on the false positive rates.
用于孕早期唐氏综合征筛查的血清生化标志物[游离β-人绒毛膜促性腺激素（fβhCG）；妊娠相关血浆蛋白-A（PAPP-A）]在辅助生殖技术受孕的妊娠中尚未得到充分研究。我们提供了通过各种辅助生殖技术受孕的妊娠数据，包括卵子捐赠（OD）后的妊娠以及大量的卵胞浆内单精子注射（ICSI）样本。
对1054例正常单胎妊娠进行孕早期唐氏综合征筛查：自然受孕（n = 498）、促排卵（OS，n = 97）、体外受精（IVF，n = 47）、ICSI（n = 222）和OD（n = 190）。
通过Kryptor系统测量，自然受孕妊娠（n = 498）与辅助生殖技术获得的妊娠（n = 556）之间，母体fβhCG和PAPP-A水平没有差异。比较不同技术之间的fβhCG水平时，有几个差异明显，但PAPP-A水平仅在OS和IVF妊娠之间有所不同（P < 0.05）。在另一项小型研究中，使用冷冻胚胎（n = 37）、植入前基因诊断（n = 53）或睾丸活检精子（n = 21）未观察到差异。
目前积累的数据表明，孕早期生化标志物要么不需要任何调整（例如在OS和ICSI后获得的妊娠中），要么对假阳性率影响很小（例如IVF妊娠）或没有影响（例如OD妊娠）。
