Department of Endocrinology and Reproductive Medicine, University Hospital, Bonn, Germany.
Reprod Biomed Online. 2010 Apr;20(4):516-22. doi: 10.1016/j.rbmo.2009.12.025. Epub 2009 Dec 28.
First-trimester serum markers in 110 in-vitro fertilization (IVF) and 331 intracytoplasmatic sperm injection (ICSI) pregnancies were compared with 1431 pregnancies with spontaneous conception. Alterations of serum markers were evaluated with respect to small-for-gestational-age (SGA) growth and number of embryos transferred. For pregnancy-associated plasma protein A (PAPP-A), significantly lower concentrations were observed in IVF and ICSI pregnancies compared with controls (0.86 and 0.9 versus 1.06; P<0.001). Free beta-human chorionic gonadotrophin (betaHCG) values were significantly higher in the IVF/ICSI groups than in controls (1.1 and 1.1 versus 0.94; P<0.005). IVF and ICSI pregnancies showed higher rates of SGA (10.0% and 8.2%) compared with natural conception (4.6%), but differences in PAPP-A concentrations remained significant (P<0.005) after the exclusion of SGA pregnancies. No relationship between serum values and the transfer of one, two or three embryos was observed. Centre-specific corrections may be needed to adjust screening parameters for assisted reproductive technology.
将 110 例体外受精（IVF）和 331 例胞浆内单精子注射（ICSI）妊娠的早孕期血清标志物与 1431 例自然受孕妊娠进行比较。根据胎儿生长受限（SGA）和胚胎移植数量评估血清标志物的变化。与对照组相比，妊娠相关血浆蛋白 A（PAPP-A）在 IVF 和 ICSI 妊娠中的浓度明显降低（0.86 和 0.9 比 1.06；P<0.001）。IVF/ICSI 组游离β-人绒毛膜促性腺激素（βHCG）值明显高于对照组（1.1 和 1.1 比 0.94；P<0.005）。与自然受孕（4.6%）相比，IVF 和 ICSI 妊娠的 SGA 发生率更高（10.0%和 8.2%），但排除 SGA 妊娠后，PAPP-A 浓度的差异仍有统计学意义（P<0.005）。未观察到血清值与移植一个、两个或三个胚胎之间存在关系。可能需要针对特定中心进行校正，以调整辅助生殖技术的筛查参数。
