Cargando…
Pregnancy Outcomes After Frozen-Thawed Embryo Transfer in the Absence of a Corpus Luteum
Background: Nowadays, frozen-thawed embryo transfer (FET) cycles represent a high proportion of fertility treatments worldwide. Recent studies suggest differences in pregnancy outcomes depending on the FET treatment protocol used. The reason for this is still unclear, but the number of corpora lutea...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8460906/ https://www.ncbi.nlm.nih.gov/pubmed/34568385 http://dx.doi.org/10.3389/fmed.2021.727753 |
_version_ | 1784571861543157760 |
---|---|
author | Waschkies, Freya Kroning, Luka Schill, Thilo Chandra, Arvind Schippert, Cordula Töpfer, Dagmar Ziert, Yvonne von Versen-Höynck, Frauke |
author_facet | Waschkies, Freya Kroning, Luka Schill, Thilo Chandra, Arvind Schippert, Cordula Töpfer, Dagmar Ziert, Yvonne von Versen-Höynck, Frauke |
author_sort | Waschkies, Freya |
collection | PubMed |
description | Background: Nowadays, frozen-thawed embryo transfer (FET) cycles represent a high proportion of fertility treatments worldwide. Recent studies suggest differences in pregnancy outcomes depending on the FET treatment protocol used. The reason for this is still unclear, but the number of corpora lutea (CL) at conception is discussed as a possible factor. This study aims to investigate whether maternal and neonatal outcomes for pregnancies following FET lacking a CL differ from FET with one or more CL in order to explore a potential link between CL absence and adverse pregnancy outcomes. Methods: The study was designed as a retrospective, multi-center observational study with two cohorts after singleton live birth [0 CL cohort (FET in a programmed cycle, n = 114) and ≥ 1 CL cohort (FET in a natural or stimulated cycle, n = 68)]. Participants completed a questionnaire on the outcome of pregnancy and birth records were analyzed in a descriptive way. Multivariable logistic and linear regressions were performed in order to explore associations between CL absence and pregnancy outcomes. The strength of the agreement between the information in the survey and the diagnoses extracted from the files was assessed by Cohen's Kappa. Results: The risk of hypertensive disorders of pregnancy was higher after FET in the absence of a CL compared to FET with CL presence (aOR 5.56, 95% CI 1.12 – 27.72). Birthweights and birthweight percentiles were significantly higher in the 0 CL group. CL absence was a predictor of higher birthweight (adjusted coefficient B 179.74, 95% CI 13.03 – 346.44) and higher birthweight percentiles (adjusted coefficient B 10.23, 95%, 95% CI 2.28 – 18.40) particularly in female newborns of the 0 CL cohort. While the strength of the agreement between the reported information in the survey and the actual diagnoses extracted from the files was good for the majority of outcomes of interest it was fair in terms of hypertension (κ = 0.38). Conclusion: This study supports observations suggesting a potential link between a lack of CL at conception and adverse maternal and neonatal outcomes. Further investigations on causes and pathophysiological relationships are yet to be conducted. |
format | Online Article Text |
id | pubmed-8460906 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-84609062021-09-25 Pregnancy Outcomes After Frozen-Thawed Embryo Transfer in the Absence of a Corpus Luteum Waschkies, Freya Kroning, Luka Schill, Thilo Chandra, Arvind Schippert, Cordula Töpfer, Dagmar Ziert, Yvonne von Versen-Höynck, Frauke Front Med (Lausanne) Medicine Background: Nowadays, frozen-thawed embryo transfer (FET) cycles represent a high proportion of fertility treatments worldwide. Recent studies suggest differences in pregnancy outcomes depending on the FET treatment protocol used. The reason for this is still unclear, but the number of corpora lutea (CL) at conception is discussed as a possible factor. This study aims to investigate whether maternal and neonatal outcomes for pregnancies following FET lacking a CL differ from FET with one or more CL in order to explore a potential link between CL absence and adverse pregnancy outcomes. Methods: The study was designed as a retrospective, multi-center observational study with two cohorts after singleton live birth [0 CL cohort (FET in a programmed cycle, n = 114) and ≥ 1 CL cohort (FET in a natural or stimulated cycle, n = 68)]. Participants completed a questionnaire on the outcome of pregnancy and birth records were analyzed in a descriptive way. Multivariable logistic and linear regressions were performed in order to explore associations between CL absence and pregnancy outcomes. The strength of the agreement between the information in the survey and the diagnoses extracted from the files was assessed by Cohen's Kappa. Results: The risk of hypertensive disorders of pregnancy was higher after FET in the absence of a CL compared to FET with CL presence (aOR 5.56, 95% CI 1.12 – 27.72). Birthweights and birthweight percentiles were significantly higher in the 0 CL group. CL absence was a predictor of higher birthweight (adjusted coefficient B 179.74, 95% CI 13.03 – 346.44) and higher birthweight percentiles (adjusted coefficient B 10.23, 95%, 95% CI 2.28 – 18.40) particularly in female newborns of the 0 CL cohort. While the strength of the agreement between the reported information in the survey and the actual diagnoses extracted from the files was good for the majority of outcomes of interest it was fair in terms of hypertension (κ = 0.38). Conclusion: This study supports observations suggesting a potential link between a lack of CL at conception and adverse maternal and neonatal outcomes. Further investigations on causes and pathophysiological relationships are yet to be conducted. Frontiers Media S.A. 2021-09-10 /pmc/articles/PMC8460906/ /pubmed/34568385 http://dx.doi.org/10.3389/fmed.2021.727753 Text en Copyright © 2021 Waschkies, Kroning, Schill, Chandra, Schippert, Töpfer, Ziert and von Versen-Höynck. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Waschkies, Freya Kroning, Luka Schill, Thilo Chandra, Arvind Schippert, Cordula Töpfer, Dagmar Ziert, Yvonne von Versen-Höynck, Frauke Pregnancy Outcomes After Frozen-Thawed Embryo Transfer in the Absence of a Corpus Luteum |
title | Pregnancy Outcomes After Frozen-Thawed Embryo Transfer in the Absence of a Corpus Luteum |
title_full | Pregnancy Outcomes After Frozen-Thawed Embryo Transfer in the Absence of a Corpus Luteum |
title_fullStr | Pregnancy Outcomes After Frozen-Thawed Embryo Transfer in the Absence of a Corpus Luteum |
title_full_unstemmed | Pregnancy Outcomes After Frozen-Thawed Embryo Transfer in the Absence of a Corpus Luteum |
title_short | Pregnancy Outcomes After Frozen-Thawed Embryo Transfer in the Absence of a Corpus Luteum |
title_sort | pregnancy outcomes after frozen-thawed embryo transfer in the absence of a corpus luteum |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8460906/ https://www.ncbi.nlm.nih.gov/pubmed/34568385 http://dx.doi.org/10.3389/fmed.2021.727753 |
work_keys_str_mv | AT waschkiesfreya pregnancyoutcomesafterfrozenthawedembryotransferintheabsenceofacorpusluteum AT kroningluka pregnancyoutcomesafterfrozenthawedembryotransferintheabsenceofacorpusluteum AT schillthilo pregnancyoutcomesafterfrozenthawedembryotransferintheabsenceofacorpusluteum AT chandraarvind pregnancyoutcomesafterfrozenthawedembryotransferintheabsenceofacorpusluteum AT schippertcordula pregnancyoutcomesafterfrozenthawedembryotransferintheabsenceofacorpusluteum AT topferdagmar pregnancyoutcomesafterfrozenthawedembryotransferintheabsenceofacorpusluteum AT ziertyvonne pregnancyoutcomesafterfrozenthawedembryotransferintheabsenceofacorpusluteum AT vonversenhoynckfrauke pregnancyoutcomesafterfrozenthawedembryotransferintheabsenceofacorpusluteum |