The Effect of In-vitro Fertilization Procedures on Alpha-fetoprotein Levels in Second Trimester Screening for Fetal Defects

Abstract

Objective Prenatal screening for developmental and chromosomal fetal defects during both the first and second trimesters of pregnancy is considered standard practice. In the second trimester, screening for spinal cord malformations, such as spina bifida and anencephaly (a type of neural tube defect), involves measuring alpha-fetoprotein levels in maternal blood. The cutoffs used to identify increased risks for neural tube defects are typically tailored for factors like race, multiple fetuses, reported smoking, and the presence of maternal insulin-dependent diabetes. What remains unclear is the impact of assisted reproductive technology, commonly known as in vitro fertilization procedures, on alpha-fetoprotein levels and other measured analytes. Method This report presents a retrospective study that examines the impact of reported in vitro fertilization procedures on second-trimester levels of alpha-fetoprotein. The study utilizes consecutive data from March 20, 2019, through March 29, 2023, sourced from laboratory records. Result We illustrate elevated levels of maternal serum alpha-fetoprotein across all racial subgroups undergoing in vitro fertilization procedures. Additionally, we demonstrate that maternal serum alpha-fetoprotein levels rise with maternal age. Conclusion This study underscores the significance of our findings in evaluating the risk of neural tube defects, such as spina bifida, Down syndrome, and other genetic anomalies. It holds considerable value in guiding clinical practices. Furthermore, it highlights the need for further investigation to evaluate how our findings impact the assessment of fetal well-being.