Department of Reproductive Medicine and Gynaecologic Endocrinology, Division of Gynaecology and Perinatology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia.
Department of Gynaecology and Perinatology, Academic HELIOS Hospital Köthen, University Martin-Luther Halle-Wittenberg, Hallesche Str. 29, 06366, Köthen (Anhalt), Germany.
J Assist Reprod Genet. 2019 Jul;36(7):1489-1495. doi: 10.1007/s10815-019-01484-z. Epub 2019 May 18.
The aim of the study was to compare the levels of angiogenic markers and markers of placentation between pregnancies conceived with fresh (ET) and vitrified-warmed blastocyst transfer (FET).
Women with singleton pregnancies resulting from fresh ET or FET during the period between 2013 and 2017 were included in this prospective observational study. Fresh ET was performed in a stimulated and FET in natural cycle. At 6-7 weeks of gestation, after ultrasound confirmation of a single gestational sac with a viable embryo, serum levels of free β-hCG, pregnancy-associated plasma protein A (PAPP-A), placental growth factor (PIGF) and fms-like tyrosine kinase (sFlt-1) were measured. Data on the patients' characteristics, pregnancy complications and outcomes were collected from a questionnaire and National Perinatal Information System of Slovenia.
Among 211 pregnancies, 126 were achieved with fresh ET and 85 with FET. There were no significant differences in perinatal outcome, pregnancy complication and PIGF level between the fresh ET and FET group. Women achieving pregnancy with FET had significant higher levels of free β-hCG (40.20 ± 30.62 IU/L vs. 28.74 ± 23.52, p = 0.002), PAPP-A (0.09 ± 0.06 vs. 0.06 ± 0.05 IU/L, p = 0.004) and sFlt-1 (596.19 ± 283.06 vs. 436.53 ± 248.23 pg/L, p < 0.0001) compared to women having conceived with fresh ET. There were no significant differences in the levels of evaluated biomarkers between patients with different pregnancy outcomes and complications.
Levels of angiogenic markers and markers of placentation differ between pregnancies achieved with fresh ET and FET which may reflect altered implantation and early placentation with some forms of assisted reproductive technologies.
本研究旨在比较新鲜胚胎移植（ET）和冷冻胚胎解冻移植（FET）妊娠的血管生成标志物和胎盘标志物水平。
本前瞻性观察性研究纳入了 2013 年至 2017 年期间接受新鲜 ET 或 FET 治疗的单胎妊娠女性。新鲜 ET 在促排卵周期中进行，FET 在自然周期中进行。在妊娠 6-7 周时，在超声确认单个有活力胚胎的孕囊后，检测血清游离β-hCG、妊娠相关血浆蛋白 A（PAPP-A）、胎盘生长因子（PIGF）和 Fms 样酪氨酸激酶 1（sFlt-1）水平。从问卷和斯洛文尼亚国家围产期信息系统收集患者特征、妊娠并发症和结局的数据。
在 211 例妊娠中，126 例为新鲜 ET 妊娠，85 例为 FET 妊娠。两组的围产结局、妊娠并发症和 PIGF 水平无显著差异。FET 妊娠组的游离β-hCG（40.20±30.62 IU/L 比 28.74±23.52 IU/L，p=0.002）、PAPP-A（0.09±0.06 IU/L 比 0.06±0.05 IU/L，p=0.004）和 sFlt-1（596.19±283.06 pg/L 比 436.53±248.23 pg/L，p<0.0001）水平显著高于新鲜 ET 妊娠组。不同妊娠结局和并发症患者的评估生物标志物水平无显著差异。
新鲜 ET 妊娠和 FET 妊娠的血管生成标志物和胎盘标志物水平不同，这可能反映了某些辅助生殖技术中植入和早期胎盘形成的改变。
