TY - JOUR
T1 - Pregnancy complications and placental histology in in vitro fertilization pregnancies with initial low serum β-hCG levels
AU - Ganer Herman, Hadas
AU - Volodarsky-Perel, Alexander
AU - Ton Nu, Tuyet Nhung
AU - Machado-Gedeon, Alexandre
AU - Cui, Yiming
AU - Shaul, Jonathan
AU - Dahan, Michael H.
N1 - Publisher Copyright:
© 2022 American Society for Reproductive Medicine
PY - 2022/12
Y1 - 2022/12
N2 - Objective: To assess perinatal outcomes and placental findings after in vitro fertilization (IVF) with an initial low serum β-human chorionic gonadotropin (hCG). Design: A retrospective cohort study. Setting: University-affiliated tertiary hospital. Intervention(s): Low serum β-hCG after transfer, defined as the low 10th percentile for the cohort on day 16 embryo age (low β-hCG group), compared with an initial serum β-hCG at or above the low 10th percentile (control group). Patient(s): Live singleton births after IVF between 2009 and 2017. Main Outcome Measure(s): Primary outcomes were placental findings, including anatomic, inflammatory, vascular malperfusion, and villous maturation lesions, as categorized according to the Amsterdam Placental Workshop Group Consensus. Secondary outcomes included obstetric and perinatal outcomes. Result(s): The low 10th percentile of β-hCG results corresponded to 149 mUI/mL. There were 103 cases in the low β-hCG group, and 928 in the control group. Maternal demographics were similar between the groups, whereas blastocyte transfer was more common in the control group. Deliveries in the low β-hCG group were associated with an increased rate of preterm births, 15.5% vs. 8.1%, which maintained significance after adjustment for confounders. Placentas in the low β-hCG group were notable for a high rate of velamentous cord insertion, 19.4% vs. 7.7%, single umbilical artery 3.8% vs. 0.6%, and histological maternal vasculopathy, 10.6% vs. 4.8%. Conclusion: Live births after IVF with an initial low β-hCG level are associated with a twofold increase in preterm births and placental gross and histological changes. It may thus be considered to observe such cases in a high-risk pregnancy setting.
AB - Objective: To assess perinatal outcomes and placental findings after in vitro fertilization (IVF) with an initial low serum β-human chorionic gonadotropin (hCG). Design: A retrospective cohort study. Setting: University-affiliated tertiary hospital. Intervention(s): Low serum β-hCG after transfer, defined as the low 10th percentile for the cohort on day 16 embryo age (low β-hCG group), compared with an initial serum β-hCG at or above the low 10th percentile (control group). Patient(s): Live singleton births after IVF between 2009 and 2017. Main Outcome Measure(s): Primary outcomes were placental findings, including anatomic, inflammatory, vascular malperfusion, and villous maturation lesions, as categorized according to the Amsterdam Placental Workshop Group Consensus. Secondary outcomes included obstetric and perinatal outcomes. Result(s): The low 10th percentile of β-hCG results corresponded to 149 mUI/mL. There were 103 cases in the low β-hCG group, and 928 in the control group. Maternal demographics were similar between the groups, whereas blastocyte transfer was more common in the control group. Deliveries in the low β-hCG group were associated with an increased rate of preterm births, 15.5% vs. 8.1%, which maintained significance after adjustment for confounders. Placentas in the low β-hCG group were notable for a high rate of velamentous cord insertion, 19.4% vs. 7.7%, single umbilical artery 3.8% vs. 0.6%, and histological maternal vasculopathy, 10.6% vs. 4.8%. Conclusion: Live births after IVF with an initial low β-hCG level are associated with a twofold increase in preterm births and placental gross and histological changes. It may thus be considered to observe such cases in a high-risk pregnancy setting.
KW - In vitro fertilization (IVF)
KW - placenta
KW - preterm birth
KW - single umbilical artery (SUA)
KW - β-hCG
UR - http://www.scopus.com/inward/record.url?scp=85139728124&partnerID=8YFLogxK
U2 - 10.1016/j.fertnstert.2022.08.852
DO - 10.1016/j.fertnstert.2022.08.852
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C2 - 36229298
AN - SCOPUS:85139728124
SN - 0015-0282
VL - 118
SP - 1058
EP - 1065
JO - Fertility and Sterility
JF - Fertility and Sterility
IS - 6
ER -