title: First- and second-trimester Down syndrome screening markers in pregnancies achieved through assisted reproductive technologies (ART): a FASTER trial study.
abstract: OBJECTIVE
  To determine whether first- and second-trimester Down syndrome screening markers and screen-positive rates are altered in pregnancies conceived using assisted reproductive technologies (ARTs).
  
  
  METHODS
  ART pregnancies in the multicenter FASTER trial were identified. Marker levels were evaluated for five types of ART: in vitro fertilization with ovulation induction (IVF-OI), IVF with OI and egg donation (IVF-OI-ED), IVF with ED (IVF-ED), and intrauterine insemination with OI (IUI-OI) or without OI (IUI). Each group was compared to non-ART controls using Mann-Whitney U analysis.
  
  
  RESULTS
  First-trimester marker levels were not significantly different between ART and control pregnancies, with the exception of reduced PAPP-A levels in the IUI-OI group. In contrast, second-trimester inhibin A levels were increased in all ART pregnancies, estriol was reduced and human chorionic gonadotropin (hCG) was increased in IVF and IUI pregnancies without ED, and alpha-fetoprotein (AFP) was increased in ED pregnancies. Second-trimester screen-positive rates were significantly higher than expected for ART pregnancies, except when ED was used.
  
  
  CONCLUSIONS
  These data show that ART significantly impacts second-, but not first-, trimester markers and screen-positive rates. The type of adjustment needed in second-trimester screening depends on the particular type of ART used.
authors.affiliation: Women and Infants Hospital and Brown Medical School, Providence, RI 02903, USA. gmesserl@wihri.org
authors.forename: G
authors.initials: G
authors.lastname: Lambert-Messerlian
authors.forename: L
authors.initials: L
authors.lastname: Dugoff
authors.forename: J
authors.initials: J
authors.lastname: Vidaver
authors.forename: J A
authors.initials: JA
authors.lastname: Canick
authors.forename: F D
authors.initials: FD
authors.lastname: Malone
authors.forename: R H
authors.initials: RH
authors.lastname: Ball
authors.forename: C H
authors.initials: CH
authors.lastname: Comstock
authors.forename: D A
authors.initials: DA
authors.lastname: Nyberg
authors.forename: G
authors.initials: G
authors.lastname: Saade
authors.forename: K
authors.initials: K
authors.lastname: Eddleman
authors.forename: S
authors.initials: S
authors.lastname: Klugman
authors.forename: S D
authors.initials: SD
authors.lastname: Craigo
authors.forename: I E
authors.initials: IE
authors.lastname: Timor-Tritsch
authors.forename: S R
authors.initials: SR
authors.lastname: Carr
authors.forename: H M
authors.initials: HM
authors.lastname: Wolfe
authors.forename: M E
authors.initials: ME
authors.lastname: D'Alton
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D016208:Databases, Factual; D004314:Down Syndrome / Q000175:diagnosis* / Q000517:prevention & control; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D010062:Ovulation Induction; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second
chemical_list: D015415:Biomarkers