title: Influence of medically assisted reproduction techniques on crown-rump length and biochemical markers of trisomy 21 in the first trimester of pregnancy.
abstract: OBJECTIVE
  To determine whether there is a difference between the known gestational age in pregnancies conceived after IVF and the estimated gestational age based on the crown-rump length (CRL) measurement during the first trimester.
  
  
  METHODS
  We retrospectively (between 2007 and 2012) studied a cohort of 6,739 patients who underwent ultrasonography between 11 and 13+6 weeks of amenorrhea.
  
  
  METHODS
  Hospital.
  
  
  METHODS
  Group A consisted of 6,621 patients with regular menses whose term was calculated based on the date of their last menstrual period (LMP). Group B consisted of 529 patients whose pregnancies had been achieved by IVF and in whom term was calculated based on the date of fresh or frozen ET.
  
  
  METHODS
  None.
  
  
  METHODS
  The gestational age difference was obtained by comparing the age obtained by measuring the CRL (Robinson's curve) with the gestational age calculated in accordance with LMP in group A or with ET day in group B.
  
  
  RESULTS
  The gestational age difference was significantly more in group B (2.3 days vs. 0.84 days in group A). We found a significant difference regarding biochemical markers for trisomy 21 to the detriment of group B with a significantly reduced pregnancy-associated protein P-A multiple of median (0.78 vs. 0.92).
  
  
  CONCLUSIONS
  There appears to be a small difference in CRL development between spontaneous pregnancies and pregnancies conceived by assisted reproductive technology (ART). Specific ultrasonographic curves for pregnancies conceived by ART would be more relevant and precise. The underlying pathophysiological mechanisms are not very clear and offer possibilities for future research.
authors.affiliation: Gynecology-obstetrics department, Centre Médico-Chirurgical et d'Obstétrique (CMCO), Schiltigheim, France. Electronic address: stephaniebonne@hotmail.fr.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Bonne
authors.affiliation: Medical informatics department, Hôpital Civil, Strasbourg, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Sauleau
authors.affiliation: Gynecology-obstetrics department, Centre Médico-Chirurgical et d'Obstétrique (CMCO), Schiltigheim, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Sananes
authors.affiliation: Gynecology-obstetrics department, Hautepierre Hospital, Strasbourg, France.
authors.forename: Cherif
authors.initials: C
authors.lastname: Akaladios
authors.affiliation: Gynecology-obstetrics department, Centre Médico-Chirurgical et d'Obstétrique (CMCO), Schiltigheim, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Rongières
authors.affiliation: Gynecology-obstetrics department, Centre Médico-Chirurgical et d'Obstétrique (CMCO), Schiltigheim, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Pirrello
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D006063:Chorionic Gonadotropin / Q000097:blood*; D018568:Crown-Rump Length; D004314:Down Syndrome / Q000097:blood / Q000175:diagnosis* / Q000235:genetics; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro; D005865:Gestational Age; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D012189:Retrospective Studies; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal
chemical_list: D015415:Biomarkers; D006063:Chorionic Gonadotropin; D011266:Pregnancy-Associated Plasma Protein-A; C579283:PAPPA protein, human
keywords: ART; PAPP-A; Robinson's curve; early fetal growth; hCG