Abstract
Research question
What are the factors associated with the increased incidence of pre-eclampsia in pregnancies
conceived through IVF using autologous oocytes?
Design
A nested case–control study from the combined cohort of three multicentre randomized
trials comparing fresh to frozen embryo transfer, including women who achieved clinical
pregnancy after the first embryo transfer. Multivariable logistic regression was used
to assess the effect of baseline characteristics, ovarian response parameters, type
of fertilization, type of embryo transfer, and number of gestational sacs on the risk
of pre-eclampsia.
Results
There were 2965 clinical pregnancies and 90 women were diagnosed with pre-eclampsia.
Twin gestations (odds ratio [OR] 2.34, 95% confidence interval [CI] 1.50–3.66), mean
arterial pressure (OR 1.04, 95% CI 1.01–1.07), frozen embryo transfer (OR 2.06, 95%
CI 1.27–3.35), body mass index (BMI) (OR 1.10, 95% CI 1.02–1.18), progesterone level
on the day of human chorionic gonadotrophin trigger (OR 1.53, 95% CI 1.07–2.20), and
the total dose of gonadotrophin (OR 0.999, 95% CI 0.999–1.000, P = 0.037) were associated with the risk of pre-eclampsia. When the analysis was confined
to women who underwent frozen embryo transfer, twin gestations (OR 2.44, 95% CI 1.43–4.18),
BMI (OR 1.13, 95% CI 1.03–1.23) and the total dose of gonadotrophin (OR 0.999, 95%
CI 0.999–1.000, P = 0.014) were still related to the risk of pre-eclampsia. The embryo stage at transfer
was not included in the final models.
Conclusions
Frozen embryo transfer was an independent risk factor of pre-eclampsia in assisted
reproductive technology. The high ovarian response may also increase the risk of pre-eclampsia.
The embryo stage at transfer was not related to the risk of pre-eclampsia.
Keywords
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Biography
Dr Yan Li is pursuing her MD at the Center for Reproductive Medicine of Shandong University, which is one of the largest IVF centres in China. Her major research interests are periconception, pregnancy and child outcomes.Key message
For women receiving assisted reproductive technology treatment, frozen embryo transfer was an independent risk factor of pre-eclampsia. The high ovarian response may also contribute to the risk of pre-eclampsia. The embryo stage at transfer was not related to the risk of pre-eclampsia. Further studies are needed to evaluate the underlying mechanism.
Article info
Publication history
Published online: September 17, 2019
Accepted:
September 11,
2019
Received in revised form:
August 13,
2019
Received:
June 5,
2019
Declaration: The authors report no financial or commercial conflicts of interest.Identification
Copyright
© 2019 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
