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Artificially prepared frozen embryo transfer cycles are associated with an increased risk of preeclampsia

  • Caroline Roelens
    Correspondence
    Corresponding Author: Caroline Roelens
    Affiliations
    Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussels 1090, Belgium
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  • Annalisa Racca
    Affiliations
    Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus Mujer, Dexeus University Hospital, 08028 Barcelona, Spain
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  • Shari Mackens
    Affiliations
    Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussels 1090, Belgium
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  • Lisbet Van Landuyt
    Affiliations
    Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussels 1090, Belgium
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  • Léonardo Gucciardo
    Affiliations
    Department of Obstetrics and Prenatal Medicine, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussels 1090, Belgium
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  • Herman Tournaye
    Affiliations
    Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussels 1090, Belgium

    Department of Obstetrics, Gynecology, Perinatology and Reproduction, Institute of Professional Education, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Trubetskaya Ulitsa, 8, 119992, Moscow, Russia
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  • Michel De Vos
    Affiliations
    Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussels 1090, Belgium
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  • Christophe Blockeel
    Affiliations
    Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Brussels 1090, Belgium

    Department of Obstetrics and Gynaecology, School of Medicine, University of Zagreb, Šalata 3, Zagreb 10000, Croatia

    Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus Mujer, Dexeus University Hospital, 08028 Barcelona, Spain
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Published:December 24, 2021DOI:https://doi.org/10.1016/j.rbmo.2021.12.004

      ABSTRACT

      Research Question

      : The aim of the current study was to investigate the association between the development of preeclampsia (PE) and the endometrial preparation prior to frozen embryo transfer (FET).

      Design

      : We conducted a retrospective cohort study at a tertiary university-based hospital. A total of 536 pregnant patients who performed a FET between 2010 and 2019 and delivered in the same institution were included. 325 patients performed a FET in a natural cycle (NC) and 211 in an artificial cycle (AC).

      Results

      : Unadjusted, the incidence of PE was significantly higher in AC-FET cycles (3.7% versus 11.8% for respectively NC-FET and AC-FET cycles, p<0.001). Multivariate logistic regression analysis showed that, when adjusting for type of endometrial preparation (AC vs NC), oocyte recipients cycles and African ethnicity, the risk of developing PE was significantly associated with artificial endometrial preparation or oocytes recipients cycles (AC-FET versus NC-FET: OR 2.9, 95% CI 1.4-6.0, p=0.005).

      Conclusions

      : Our data show a higher incidence of PE in AC-FET versus in NC-FET cycles, adding further strength to the existing data on this topic. Together, these recent findings may result in a change in clinical practice towards a preference for NC-FET cycles instead of AC-FET cycles in ovulatory patients. Screening for high risk patients and the development of strategies to mitigate their risk profile could reduce the risk of PE. Further understanding of the different vasoactive substances excreted by the corpus luteum is mandatory.
      Study funding/competing interest(s): not applicable
      Trial registration number: Not applicable

      Key words

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      Biography

      Caroline Roelens, MD, obtained her medical degree in 2013 at the Vrije Universiteit Brussel, Belgium. She completed her training in obstetrics and gynecology in 2019 and started a 2-years specialization in reproductive medicine at the Centre for Reproductive Medicine in Brussels, Belgium were she is now working as a Junior Medical Director. Main topic of interest is the optimization of frozen-embryo transfer cycles.
      Key Message
      Frozen embryo transfer cycles account for an increasing share of all performed assisted reproductive techniques. Artificially prepared frozen embryo transfer cycles are associated with a higher incidence of hypertensive disorder of pregnancy. Correct diagnosis and identification of patients at high risk for preeclampsia is indispensable.