Department of Obstetrics and Gynaecology, Institute of Clinical Sciences Lund, Lund University., Klinikgatan 28, BMC C14, Lund 221 85, Sweden; BCNatal, Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Sabino Arana 1 Barcelona 08028, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Roselló 149-153 Barcelona 08036, Spain.
Department of Obstetrics and Gynaecology, Institute of Clinical Sciences Lund, Lund University., Klinikgatan 28, BMC C14, Lund 221 85, Sweden; BCNatal, Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Sabino Arana 1 Barcelona 08028, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Roselló 149-153 Barcelona 08036, Spain.
Reprod Biomed Online. 2022 Jul;45(1):135-145. doi: 10.1016/j.rbmo.2022.01.005. Epub 2022 Jan 18.
Do pregnancies with corpus luteum show different maternal and fetal plasma concentrations of the scavenger proteins haemopexin and α-microglobulin compared with pregnancies without corpus luteum in preeclampsia?
Case-control study of 160 singleton pregnancies: 54 naturally conceived, 50 by IVF after fresh embryo transfer or frozen embryo transfer (FET) in natural cycle (presence of corpus luteum) and 56 after fresh oocyte donation or FET in programmed cycles (absence of corpus luteum). Pregnancies were subclassified into normotensive, preeclampsia and severe preeclampsia cases. Heme-scavenger concentrations were measured by ELISA in maternal and cord plasma collected at delivery.
After adjustment, maternal haemopexin was higher in IVF with corpus luteum than in naturally conceived pregnancies in normotensive (P = 0.038) and preeclampsia (P = 0.011) populations, and lower in preeclampsia for IVF pregnancies lacking corpus luteum compared with IVF with corpus luteum (P = 0.002). Maternal α-microglobulin levels were higher in the absence of corpus luteum only in severe cases of preeclampsia compared with naturally conceived pregnancies (P = 0.014) and IVF with corpus luteum pregnancies (P = 0.041). In cord blood, haemopexin was higher in IVF with corpus luteum compared with naturally conceived pregnancies in preeclampsia (P = 0.039) and α-microglobulin was higher in the group lacking corpus luteum compared with IVF with corpus luteum in the normotensive population (P < 0.001).
The physiological differences shown for these heme-scavengers between pregnancies after embryo transfer in the presence or absence of corpus luteum support the hypothesis that corpus luteum activity could influence perinatal outcomes. Future research is needed on whether applying potential strategies to develop a corpus luteum might reduce the perinatal complications associated with programmed cycles of IVF.
与黄体期缺失的子痫前期相比，黄体期存在的自然受孕、新鲜胚胎移植或冻融胚胎移植（IVF）后以及新鲜卵母细胞捐赠或程序化周期 FET 后妊娠的母体和胎儿血浆中 scavenger 蛋白血红素结合蛋白和 α-微球蛋白的浓度是否不同？
160 例单胎妊娠的病例对照研究：54 例自然受孕，50 例新鲜胚胎移植或冻融胚胎移植（IVF）后在自然周期（黄体期存在），56 例新鲜卵母细胞捐赠或程序化周期 FET 后（黄体期缺失）。妊娠分为正常血压、子痫前期和重度子痫前期病例。分娩时采集母血和脐血，用 ELISA 法测定血红素结合蛋白浓度。
调整后，黄体期 IVF 妊娠的母体血红素结合蛋白水平高于正常血压（P=0.038）和子痫前期（P=0.011）人群中的自然受孕，黄体期缺失的子痫前期 IVF 妊娠中的母体血红素结合蛋白水平低于黄体期 IVF 妊娠（P=0.002）。只有重度子痫前期病例的母体α-微球蛋白水平在黄体期缺失时才升高，与自然受孕（P=0.014）和黄体期 IVF 妊娠（P=0.041）相比。在脐血中，黄体期 IVF 妊娠的母体血红素结合蛋白水平高于自然受孕妊娠的子痫前期（P=0.039），黄体期缺失的 IVF 妊娠的母体α-微球蛋白水平高于黄体期 IVF 妊娠的正常血压人群（P<0.001）。
胚胎移植后黄体期存在或缺失时这些血红素结合蛋白的生理差异支持黄体期活动可能影响围产期结局的假说。需要进一步研究是否应用潜在的策略来形成黄体期是否可以降低与 IVF 程序化周期相关的围产期并发症。
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