Comparison of nuchal translucency measurement and mid-gestation serum screening in assisted reproduction versus naturally conceived singleton pregnancies.
It has been reported that second-trimester serum markers may be affected by assisted reproduction leading to a higher false-positive rate. The current study compares 10-14 week nuchal translucency (NT) measurement and early mid-trimester serum screening in pregnancies resulting from assisted reproduction versus naturally conceived pregnancies. 75 pregnant women with a singleton pregnancy achieved by assisted reproduction underwent both 10-14 weeks NT measurement and second-trimester triple test and were followed throughout gestation. They were compared with matched controls for gestation and maternal ages. A risk of 1:380 or higher or having a fetus with Down syndrome was considered as screen-positive in both tests. The mean maternal age (30+/-3 years) and crown-rump length (61+/-9 mm) were similar, and there was no difference in NT thickness distribution between the groups. Based on NT measurement, 4 (5 per cent) women in the study and 2 (3 per cent) in the control groups, were defined as screen positive (p=NS). However, 11 (15 per cent) women in the study group and 4 (5 per cent) in the control group were found screen-positive by the triple test (p<0.05). A significantly higher amniocentesis rate of 20 per cent was noted in the study group compared with 8 per cent in the controls (p<0.05). All karyotypes were normal and no miscarriages or structural malformation were diagnosed in either group. We confirm the observation that assisted reproduction may adversely affect second-trimester screening results, which did not affect the NT screening test. Since these series are relatively small, larger series may be needed to clarify the most beneficial screening policy for this highly selected group of pregnant women.
Maymon
R
R
Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Sackler Faculty of Medicine, Tel Aviv University, Israel.
Dreazen
E
E
Rozinsky
S
S
Bukovsky
I
I
Weinraub
Z
Z
Herman
A
A
D000328:Adult; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D006063:Chorionic Gonadotropin / Q000097:blood; D004314:Down Syndrome / Q000175:diagnosis*; D004964:Estriol / Q000097:blood; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012099:Reproductive Techniques; D016216:Ultrasonography, Prenatal / Q000592:standards*; D000509:alpha-Fetoproteins
D015415:Biomarkers; D006063:Chorionic Gonadotropin; D000509:alpha-Fetoproteins; D004964:Estriol