Sara J Churchill1, Erica T Wang2, Marcy Akhlaghpour1, Ellen H Goldstein2, Dina Eschevarria3, Naomi Greene3, Matthew Macer2, Temeka Zore2, John Williams4, Margareta D Pisarska5. 1. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, California. 2. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, California. 3. David Geffen School of Medicine, University of California, Los Angeles, California. 4. David Geffen School of Medicine, University of California, Los Angeles, California; Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Cedars-Sinai Medical Center, Los Angeles, California. 5. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, California; David Geffen School of Medicine, University of California, Los Angeles, California. Electronic address: pisarskam@cshs.org.
Abstract
OBJECTIVE: To study whether infertility treatments, including IVF and non-IVF fertility treatments, are associated with diseases of placental insufficiency in early gestation. First trimester placental volumes by ultrasound and chorionic villi weight during sampling (CVS) were performed to detect differences between pregnancies conceived spontaneously versus with fertility treatments. DESIGN: Retrospective cohort. SETTING: Academic tertiary center. PATIENT(S): Women with singleton pregnancies undergoing CVS and first trimester ultrasound from April 2007 to November 2015. INTERVENTION(S): Estimated placental volume (EPV) was calculated from ultrasound images using a validated computation and CVS estimated tissue weight was performed using a validated visual analogue scale. MAIN OUTCOME MEASURE(S): Adjusted linear regression was used to compare EPV and CVS weight based on mode of conception. RESULT(S): A total of 1,977 spontaneous and 334 conceived with fertility treatments (133 non-IVF and 201 IVF) pregnancies were included. Significant differences in maternal age, gravidity, hypertension, and smoking status were identified. EPV and CVS weight were correlated with maternal age, gestational age, and maternal hypertension. Adjusted linear regression showed no difference in EPV in pregnancies conceived with fertility treatments versus spontaneously. The CVS weight was significantly lower in the IVF conceptions in unadjusted univariate analyses. However, after adjusted regression, this was no longer significant. CONCLUSION(S): Mode of conception does not appear to affect first trimester placental size. As differences in maternal age, hypertension, and smoking status differ among the groups and are correlated to placental size, it may be the underlying patient population leading to abnormal placentation and insufficiency, not the fertility treatments used.
OBJECTIVE: To study whether infertility treatments, including IVF and non-IVF fertility treatments, are associated with diseases of placental insufficiency in early gestation. First trimester placental volumes by ultrasound and chorionic villi weight during sampling (CVS) were performed to detect differences between pregnancies conceived spontaneously versus with fertility treatments. DESIGN: Retrospective cohort. SETTING: Academic tertiary center. PATIENT(S): Women with singleton pregnancies undergoing CVS and first trimester ultrasound from April 2007 to November 2015. INTERVENTION(S): Estimated placental volume (EPV) was calculated from ultrasound images using a validated computation and CVS estimated tissue weight was performed using a validated visual analogue scale. MAIN OUTCOME MEASURE(S): Adjusted linear regression was used to compare EPV and CVS weight based on mode of conception. RESULT(S): A total of 1,977 spontaneous and 334 conceived with fertility treatments (133 non-IVF and 201 IVF) pregnancies were included. Significant differences in maternal age, gravidity, hypertension, and smoking status were identified. EPV and CVS weight were correlated with maternal age, gestational age, and maternal hypertension. Adjusted linear regression showed no difference in EPV in pregnancies conceived with fertility treatments versus spontaneously. The CVS weight was significantly lower in the IVF conceptions in unadjusted univariate analyses. However, after adjusted regression, this was no longer significant. CONCLUSION(S): Mode of conception does not appear to affect first trimester placental size. As differences in maternal age, hypertension, and smoking status differ among the groups and are correlated to placental size, it may be the underlying patient population leading to abnormal placentation and insufficiency, not the fertility treatments used.
Authors: Ning Xu; Gillian M Barlow; Jinrui Cui; Erica T Wang; Bora Lee; Marzieh Akhlaghpour; Lindsay Kroener; John Williams; Jerome I Rotter; Yii-der I Chen; Mark O Goodarzi; Margareta D Pisarska Journal: Reprod Sci Date: 2016-11-14 Impact factor: 3.060
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Authors: M S Rifouna; A D Reus; A H J Koning; P J van der Spek; N Exalto; E A P Steegers; J S E Laven Journal: Hum Reprod Date: 2014-10-21 Impact factor: 6.918
Authors: Saswati Sunderam; Dmitry M Kissin; Lisa Flowers; John E Anderson; Suzanne G Folger; Denise J Jamieson; Wanda D Barfield Journal: MMWR Surveill Summ Date: 2012-11-02