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体外受精或体外受精/卵胞浆内单精子注射妊娠中孕早期滋养层和胎盘床血管容积测量

First trimester trophoblast and placental bed vascular volume measurements in IVF or IVF/ICSI pregnancies.

作者信息

Rifouna M S, Reus A D, Koning A H J, van der Spek P J, Exalto N, Steegers E A P, Laven J S E

机构信息

Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Center, Rotterdam, 3000 CA, The Netherlands.

Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Center, Rotterdam, 3000 CA, The Netherlands

出版信息

Hum Reprod. 2014 Dec;29(12):2644-9. doi: 10.1093/humrep/deu273. Epub 2014 Oct 21.

Abstract

STUDY QUESTION

Are first trimester trophoblast volume (TV) and placental bed vascular volume (PBVV) different in IVF or IVF/ICSI pregnancies in comparison with spontaneously conceived pregnancies?

SUMMARY ANSWER

Any possible abnormal placentation in IVF or IVF/ICSI pregnancies in comparison with spontaneously conceived pregnancies is not detected by a difference in PBVV or TV at an early gestational age (GA).

WHAT IS KNOWN ALREADY

Assisted reproductive technology pregnancies have been associated with an increased risk of placenta-related adverse pregnancy outcomes. It is unclear whether these effects originate from infertility or from the technique itself.

STUDY DESIGN, SIZE, DURATION: We performed a retrospective cohort study in which 154 pregnant patients qualified for participation.

PARTICIPANTS/MATERIALS, SETTING, METHODS: Out of 154 pregnant patients, 84 conceived spontaneously and 70 conceived after IVF or IVF/ICSI. We determined the TV at 10 weeks GA by Virtual Organ Computer-aided AnaLysis measuring application and the PBVV at 12 weeks GA by the virtual reality operating system of BARCO I-Space in both subgroups. The investigators were blinded to the mode of conception during the measurements. Analysis was limited to singleton pregnancies with only one sac ever detectable.

MAIN RESULTS AND THE ROLE OF CHANCE

There were no differences in TV (mean 42.7, SD 15.9 versus mean 41.2, SD 13.9, P = 0.70) and PBVV (mean 27.6, SD 16.9 versus mean 24.8, SD 19.9, P = 0.20) between IVF or IVF/ICSI pregnancies and spontaneously conceived pregnancies. There was a significant correlation between TV and PBVV (rs = 0.283, P = 0.004).

LIMITATIONS, REASONS FOR CAUTION: The limitations of the present study concern the small size of the study groups.

WIDER IMPLICATIONS OF THE FINDINGS

IVF or IVF/ICSI does not seem to be associated with abnormal placentation.

STUDY FUNDING/COMPETING INTERESTS: This study was financially supported by the Erasmus Trustfonds, the Meindert de Hoop foundation and the Fonds NutsOhra. No competing interests are declared.

摘要

研究问题

与自然受孕的妊娠相比,体外受精(IVF)或卵胞浆内单精子注射(IVF/ICSI)妊娠的孕早期滋养层体积(TV)和胎盘床血管体积(PBVV)是否存在差异?

简要回答

在孕早期(GA),PBVV或TV的差异未检测到IVF或IVF/ICSI妊娠与自然受孕妊娠相比存在任何可能的胎盘形成异常。

已知信息

辅助生殖技术妊娠与胎盘相关不良妊娠结局的风险增加有关。目前尚不清楚这些影响是源于不孕症还是技术本身。

研究设计、规模、持续时间:我们进行了一项回顾性队列研究,其中154名孕妇符合参与条件。

参与者/材料、设置、方法:在154名孕妇中,84名自然受孕,70名在IVF或IVF/ICSI后受孕。我们通过虚拟器官计算机辅助分析测量应用程序在孕10周时测定TV,并通过BARCO I-Space虚拟现实操作系统在孕12周时测定两个亚组的PBVV。测量期间,研究人员对受孕方式不知情。分析仅限于仅可检测到一个孕囊的单胎妊娠。

主要结果及机遇的作用

IVF或IVF/ICSI妊娠与自然受孕妊娠之间的TV(平均42.7,标准差15.9对平均41.2,标准差13.9,P = 0.70)和PBVV(平均27.6,标准差16.9对平均24.8,标准差19.9 P = 0.20)没有差异。TV和PBVV之间存在显著相关性(rs = 0.283,P = 0.004)。

局限性、谨慎的原因:本研究的局限性在于研究组规模较小。

研究结果的更广泛影响

IVF或IVF/ICSI似乎与胎盘形成异常无关。

研究资金/利益冲突:本研究得到伊拉斯谟信托基金、明德特·德·胡普基金会和努茨奥拉基金会的资助。未声明存在利益冲突。

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