Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, University of Southern California, Los Angeles, CA, USA.
Department of Obstetrics and Gynecology, LAC+USC Medical Center, University of Southern California, 2020 Zonal Avenue IRD 534, Los Angeles, CA, 90033, USA.
J Assist Reprod Genet. 2017 Dec;34(12):1639-1643. doi: 10.1007/s10815-017-1023-2. Epub 2017 Sep 4.
We aimed to investigate the angiogenic balance in fresh compared to frozen embryo transfers, and among neonates with adverse perinatal outcomes.
This was a retrospective cohort study. All IVF cycles resulting in a singleton live birth at a university academic fertility center from January 1, 2011, to December 31, 2013, were examined. Concentrations of sFLT-1 and PlGF were measured in previously frozen serum specimens collected during early gestation at approximately 5 weeks gestation. Patients completed an electronic survey to detail perinatal outcome.
We identified 152 singleton live births (103 fresh, 49 frozen). Demographic characteristics were similar between the two groups. Ratios of sFlt-1:PlGF were not different between fresh and frozen transfers. Neonates from fresh cycles had a mean birth weight 202 g lighter (p = 0.01) than frozen cycles, after adjusting for gestational age. Among babies born with poor perinatal outcomes, there was a difference in sFlt-1:PlGF ratios after adjusting for race. In non-Asians, infants born small for gestational age (SGA) (< 10th percentile) had significantly higher sFLT-1:PLGF ratio, median ratio (0.21 vs 0.12, p = 0.016).
Fresh transfers were associated with lower birth weight infants compared to frozen transfers. While there was no difference in sFlt-1:PlGF ratios between fresh and frozen transfers, these ratios were significantly lower in SGA infants, suggesting an imbalance in angiogenic markers during placentation.
本研究旨在比较新鲜胚胎移植与冷冻胚胎移植以及围产儿不良结局儿之间的血管生成平衡。
本研究为回顾性队列研究。纳入 2011 年 1 月 1 日至 2013 年 12 月 31 日在某大学学术生育中心进行的所有 IVF 周期中单胎活产。于妊娠早期（妊娠 5 周左右）收集并冻存血清标本，检测 sFLT-1 和 PlGF 浓度。患者完成电子问卷调查以详细了解围产儿结局。
共纳入 152 例单胎活产（新鲜胚胎移植 103 例，冷冻胚胎移植 49 例）。两组患者的人口统计学特征相似。新鲜胚胎移植与冷冻胚胎移植组 sFlt-1:PlGF 比值无差异。校正胎龄后，新鲜胚胎移植组新生儿出生体重比冷冻胚胎移植组低 202g（p=0.01）。校正种族因素后，围产儿不良结局儿的 sFlt-1:PlGF 比值存在差异。非亚洲人组中，小于胎龄儿（SGA）（<10 百分位数）的婴儿 sFLT-1:PLGF 比值显著升高，中位数比值（0.21 比 0.12，p=0.016）。
与冷冻胚胎移植相比，新鲜胚胎移植组新生儿出生体重较低。虽然新鲜胚胎移植与冷冻胚胎移植组的 sFlt-1:PlGF 比值无差异，但 SGA 新生儿的比值明显较低，提示胎盘形成过程中血管生成标志物失衡。
