Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, OR, USA.
Division of Nephrology & Hypertension, Department of Medicine, Oregon Health & Science University, Portland, OR, USA.
Curr Hypertens Rep. 2023 Sep;25(9):251-261. doi: 10.1007/s11906-023-01250-8. Epub 2023 Jun 12.
We summarized recent available data to assess the association between assisted reproductive technology (ART) and risk for preeclampsia.
The majority of clinical studies supporting the association of preeclampsia and ART are retrospective. Published data from both clinical and pre-clinical studies suggest specific ART procedures may contribute to the increased risk, including in vitro embryo handling and development, hormone stimulation, transfer cycle types, and use of donor oocytes/embryos. Potential mechanisms include epigenetic aberrations leading to abnormal placentation, absence of factors secreted by the corpus luteum, and immunologic responses to allogenic gametes. There is an increased risk of preeclampsia following ART. Treatment plans that favor reduced preeclampsia risk should be considered for ART pregnancies. To make ART pregnancies safer, additional clinical and animal model studies are needed to elucidate the underpinnings of this risk association.
我们总结了最新的可用数据,以评估辅助生殖技术(ART)与子痫前期风险之间的关系。
支持子痫前期与 ART 相关的大多数临床研究都是回顾性的。来自临床和临床前研究的已发表数据表明,特定的 ART 程序可能会增加风险,包括体外胚胎处理和发育、激素刺激、移植周期类型以及使用供体卵/胚胎。潜在的机制包括导致异常胎盘形成的表观遗传异常、黄体分泌因子的缺失以及同种配子的免疫反应。ART 后子痫前期的风险增加。对于 ART 妊娠,应考虑制定有利于降低子痫前期风险的治疗计划。为了使 ART 妊娠更安全,需要进行更多的临床和动物模型研究,以阐明这种风险关联的基础。