Service de Gynécologie-Obstétrique, CHU Dijon Bourgogne, Dijon, France.
Service de Gynécologie-Obstétrique, CHU Dijon Bourgogne, Dijon, France; Université Bourgogne Franche-Comté-INSERM UMR1231, Dijon, France.
Fertil Steril. 2018 Nov;110(6):1109-1117.e2. doi: 10.1016/j.fertnstert.2018.06.030.
To study the impact of in vitro fertilization, with or without intracytoplasmic sperm injection (IVF/ICSI), frozen-embryo transfer (FET), and intrauterine insemination (IUI) on fetal growth kinetics throughout pregnancy and to compare the different modes of conception.
Retrospective cohort study.
University.
PATIENT(S): A total of 560 singleton pregnancies were included (96 IVF, 210 ICSI, 121 FET, and 133 IUI).
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): We compared crown-rump length (CRL) at the first trimester (T1: 11-13 weeks of gestation [WG] + 6 days), estimated fetal weight (EFW) at the second (T2: 21-23 WG + 6 days) and third (T3: 31-33 WG + 6 days) trimesters, and birth weight (BW) z-scores with those in the reference curves (Papageorghiou for T1, and Ego M2 for T2, T3, and birth). Multivariate analyses were performed.
RESULT(S): For T1, the CRL was longer than the reference curve whatever the assisted reproductive technique (ART). For T2, EFW was significantly greater for all groups compared with the reference curve, and for T3 only FET singletons had a greater EFW. ICSI, IVF, and IUI singletons had a significantly lower BW compared with reference curves. For all ART fetuses, growth kinetics differed from T2. Only FET fetuses maintained their significantly above-reference growth values. The proportion of fetuses for which at least one period of growth loss was observed from T2 to birth was higher after IVF, ICSI, and IUI than after FET.
CONCLUSION(S): For the first time, we have highlighted that fetal growth kinetics differed from T2 depending on the ART protocols used. They could have an impact on trophoblastic invasiveness and might lead to long-term health effects.
研究体外受精（IVF）联合或不联合胞浆内单精子注射（ICSI）、冻融胚胎移植（FET）和宫腔内人工授精（IUI）对整个孕期胎儿生长动力学的影响，并比较不同受孕方式。
回顾性队列研究。
大学。
共纳入 560 例单胎妊娠（96 例 IVF、210 例 ICSI、121 例 FET 和 133 例 IUI）。
无。
比较头臀长（CRL）在孕早期（T1：妊娠 11-13 周+6 天）、孕中期（T2：妊娠 21-23 周+6 天）和孕晚期（T3：妊娠 31-33 周+6 天）的估计胎儿体重（EFW）和出生体重（BW）Z 评分与参考曲线（T1 为 Papageorghiou，T2、T3 和出生为 Ego M2）的差异。进行多变量分析。
T1 时，无论辅助生殖技术（ART）如何，CRL 均长于参考曲线。T2 时，所有组的 EFW 均显著大于参考曲线，而 T3 时仅 FET 单胎的 EFW 更大。ICSI、IVF 和 IUI 单胎的 BW 明显低于参考曲线。对于所有 ART 胎儿，与 T2 相比，生长动力学均不同。只有 FET 胎儿的生长值保持显著高于参考值。从 T2 到出生至少有一个生长减速期的胎儿比例，在 IVF、ICSI 和 IUI 后高于 FET。
这是首次强调，胎儿生长动力学因所使用的 ART 方案而异。它们可能对滋养细胞浸润有影响，并可能导致长期健康影响。
