September 27th, 2020

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First-Trimester Serum-Based Screening for Aneuploidy in Pregnancy Achieved by Assisted Reproductive Technology
Authors:  Ding Wang, Ph.D., Rui Chen, Ph.D., Guanhui Wei, B.D., Yexing Xian, M.D., Yingjun Xie, M.D., and Xiaofang Sun, Ph.D.
  OBJECTIVE: To determine whether characteristic biochemical and ultrasound markers of assisted reproductive technology (ART) and natural (non-ART) pregnancy provide knowledge regarding the impact of ART on Down syndrome occurrence and whether these markers are beneficial for first-trimester aneuploidy screening.

STUDY DESIGN: This was a retrospective analysis of free β-hCG and pregnancy-associated plasma protein A (PAPP-A) levels in 8,124 naturally conceived singleton pregnancies and 1,153 singleton ART pregnancies (intracytoplasmic sperm injection [n=903] or in vitro fertilization [n=250]) in ethnically South Asian women. In addition to demographic information, we collected data on nuchal translucency (NT) thickness and free β-hCG and PAPP-A maternal serum concentrations, and these data were compared between the two groups.

RESULTS: The ART group had a significantly lower PAPP-A level (p<0.001) and higher NT thickness (p<0.001) than did the non-ART group. Additionally, we found that for non-ART pregnancies, free β-hCG, PAPP-A, and NT were all correlated with age, weight, and gestation days, while for ART pregnancies these three indicators were correlated with different demographic features.

CONCLUSION: This study estimated the effects of ART on pregnancy serum-based screening for aneuploidy, and the results suggest that these women should be advised to undergo prenatal diagnosis in first-trimester screening based on specific free β-hCG and PAPP-A levels and NT thickness.
Keywords:  assisted reproductive technology, Down syndrome/diagnosis, first-trimester serum-based screening, nuchal translucency, free β-hCG, PAPP-A, pregnancy, pregnancy-associated plasma protein-A, prenatal diagnosis, risk factors
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