Influence of trophectoderm biopsy for preimplantation genetic testing in the serum level of first trimester biomarkers

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY Reproductive biomedicine online Pub Date : 2025-03-01 DOI:10.1016/j.rbmo.2024.104490

Pilar Prats , María Gabriela Palacios-Verdú , Alberto Rodríguez-Melcón , Ignacio Rodríguez , Bernat Serra , Mónica Parriego , Valeria Donno , Nikolaos P. Polyzos

{"title":"Influence of trophectoderm biopsy for preimplantation genetic testing in the serum level of first trimester biomarkers","authors":"Pilar Prats , María Gabriela Palacios-Verdú , Alberto Rodríguez-Melcón , Ignacio Rodríguez , Bernat Serra , Mónica Parriego , Valeria Donno , Nikolaos P. Polyzos","doi":"10.1016/j.rbmo.2024.104490","DOIUrl":null,"url":null,"abstract":"<div><h3>Research question</h3><div>Does trophectoderm biopsy for preimplantation genetic testing for aneuploidies (PGT-A) affect maternal serum first-trimester pregnancy biomarkers (pregnancy-associated plasma protein A [PAPP-A], free β-HCG and placental growth factor [PIGF])?</div></div><div><h3>Design</h3><div>Retrospective cohort study of all singleton pregnancies (<em>n</em> = 9794) after naturally conceived (<em>n</em> = 8005) IVF and fresh embryo transfers (<em>n</em> = 478), frozen embryo transfer of non PGT-A (FET) (<em>n</em> = 963) or PGT-A tested embryos (FET + PGT-A) (<em>n</em> = 348). Serum levels of free β-HCG and PAPP-A were measured in all women with a viable pregnancy at 8–13.6 weeks of pregnancy; PIGF was measured in 3784 women. Biomarkers were converted to a multiple of the expected normal median (MOM) for a pregnancy of the same gestational day. The medians for the multiple of the median were calculated and compared.</div></div><div><h3>Results</h3><div>Free β-HCG did not differ according to mode of conception. The PAPP-A concentrations were significantly lower in IVF and fresh embryo transfers (–0.1 Log10 MOM raw PAPP-A) compared with FET + PGT-A (–0.04 Log 10 MOM raw PAPP-A, <em>P</em> = 0.009) and natural conceptions (–0.0187 Log 10 MOM raw PAPP-A) (<em>P</em> < 0.001). The PIGF levels were significantly lower in the FET + PGTA group versus natural conception (<em>P</em> = 0.001). Difference in means adjusted by crown rump length was 4.6 pg/ml (95% CI 2.7 to 6.6) for natural conceptions, 3.5 pg/ml (95% CI 0.34 to 6.6) for IVF and 2.2 pg/ml (95% CI 0.06 to 4.4) for FET.</div></div><div><h3>Conclusion</h3><div>Trophectoderm biopsy for PGT-A has a significant effect on first-trimester maternal serum PAPP-A and PIGF. This needs to be further validated, as it may mislead the estimation of the first-trimester risk of aneuploidies and pre-eclampsia.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"50 3","pages":"Article 104490"},"PeriodicalIF":3.7000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reproductive biomedicine online","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1472648324006795","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Research question

Does trophectoderm biopsy for preimplantation genetic testing for aneuploidies (PGT-A) affect maternal serum first-trimester pregnancy biomarkers (pregnancy-associated plasma protein A [PAPP-A], free β-HCG and placental growth factor [PIGF])?

Design

Retrospective cohort study of all singleton pregnancies (n = 9794) after naturally conceived (n = 8005) IVF and fresh embryo transfers (n = 478), frozen embryo transfer of non PGT-A (FET) (n = 963) or PGT-A tested embryos (FET + PGT-A) (n = 348). Serum levels of free β-HCG and PAPP-A were measured in all women with a viable pregnancy at 8–13.6 weeks of pregnancy; PIGF was measured in 3784 women. Biomarkers were converted to a multiple of the expected normal median (MOM) for a pregnancy of the same gestational day. The medians for the multiple of the median were calculated and compared.

Results

Free β-HCG did not differ according to mode of conception. The PAPP-A concentrations were significantly lower in IVF and fresh embryo transfers (–0.1 Log10 MOM raw PAPP-A) compared with FET + PGT-A (–0.04 Log 10 MOM raw PAPP-A, P = 0.009) and natural conceptions (–0.0187 Log 10 MOM raw PAPP-A) (P < 0.001). The PIGF levels were significantly lower in the FET + PGTA group versus natural conception (P = 0.001). Difference in means adjusted by crown rump length was 4.6 pg/ml (95% CI 2.7 to 6.6) for natural conceptions, 3.5 pg/ml (95% CI 0.34 to 6.6) for IVF and 2.2 pg/ml (95% CI 0.06 to 4.4) for FET.

Conclusion

Trophectoderm biopsy for PGT-A has a significant effect on first-trimester maternal serum PAPP-A and PIGF. This needs to be further validated, as it may mislead the estimation of the first-trimester risk of aneuploidies and pre-eclampsia.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

求助全文

约1分钟内获得全文去求助

来源期刊

Reproductive biomedicine online 医学-妇产科学

CiteScore

7.20

自引率

7.50%

发文量

391

审稿时长

50 days

期刊介绍： Reproductive BioMedicine Online covers the formation, growth and differentiation of the human embryo. It is intended to bring to public attention new research on biological and clinical research on human reproduction and the human embryo including relevant studies on animals. It is published by a group of scientists and clinicians working in these fields of study. Its audience comprises researchers, clinicians, practitioners, academics and patients. Context: The period of human embryonic growth covered is between the formation of the primordial germ cells in the fetus until mid-pregnancy. High quality research on lower animals is included if it helps to clarify the human situation. Studies progressing to birth and later are published if they have a direct bearing on events in the earlier stages of pregnancy.