Serum PAPP-A levels at 10-14 weeks of gestation are altered in women after assisted conception.
OBJECTIVE
Increased screen-positive rate was observed in the first-trimester screening for trisomy 21 (T21) among women after assisted conception. The aim of this study was to identify the trends of changes in serum marker levels after different modes of assisted conception.


METHODS
Retrospectively, we analyzed the levels of free beta human chorionic gonadotrophin (f beta HCG), pregnancy-associated plasma protein-A (PAPP-A) and inhibin A in maternal serum, and fetal nuchal translucency (NT) thickness at 10-14 gestational weeks in 1098 women with singleton pregnancies: 130 after IVF-ET, 54 after ICSI and 914 after spontaneous conception.


RESULTS
In women after IVF-ET and ICSI, PAPP-A was decreased (0.94 MoM and 0.82 MoM, respectively) and inhibin A increased (1.11 MoM and 1.48 MoM, respectively) in comparison to the women after spontaneous conception. With increasing number of oocytes retrieved PAPP-A decreased and inhibin A increased. In women pregnant after assisted conception without ovarian stimulation (transfer of frozen-thawed embryo or in spontaneous cycle) the marker levels were not significantly different from those in women after spontaneous conception.


CONCLUSIONS
The presence of multiple corpora lutea may be responsible for the changes in marker levels. In spite of the differences in marker levels, the screen-positive rate for T21 is not significantly increased in women after assisted conception.
Tul
Natasa
N
Division for Perinatology, Department of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia. natasa.tul@guest.arnes.si
Novak-Antolic
Ziva
Z
D000328:Adult; D015415:Biomarkers / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D004314:Down Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D005865:Gestational Age; D006801:Humans; D007265:Inhibins / Q000097:blood; D048208:Nuchal Translucency Measurement; D016017:Odds Ratio; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis / Q000378:metabolism*; D012189:Retrospective Studies; D018570:Risk Assessment; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects*
D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; C422362:inhibin A; D007265:Inhibins; D011266:Pregnancy-Associated Plasma Protein-A