Maternal serum pregnancy-associated plasma protein-A and free β-human chorionic gonadotrophin in pregnancies conceived with fresh and frozen-thawed embryos fromin vitro fertilization and intracytoplasmic sperm injection

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Abstract
Objective Maternal serum pregnancy‐associated plasma protein‐A (PAPP‐A) and free β‐human chorionic gonadotrophin (β‐hCG) are useful markers in the screening of Down syndrome in the first trimester. We investigated the effect of intracytoplasmic sperm injection (ICSI), freezing and thawing of embryos on the levels of these two analytes in assisted reproduction pregnancies. Methods We recruited 149 women who conceived after assisted reproduction with fresh embryos (92 from conventional IVF and 57 from ICSI), 85 women who conceived with frozen‐thawed embryos (54 from conventional IVF and 31 from ICSI) and 401 women with spontaneous conceptions as controls. The concentrations of PAPP‐A and free β‐hCG were measured between 10 and 14 weeks and were converted to multiples of medians (MoM) for comparisons. Results Median PAPP‐A MoMs were significantly reduced in ICSI pregnancies in the fresh and frozen‐thawed embryo subgroups (0.70 and 0.66 MoM respectively) and in the IVF fresh embryo subgroups (0.83 MoM), as compared to controls (1.00 MoM). Free β‐hCG MoM was significantly reduced in the IVF fresh embryos subgroup (0.87 MoM), but not in the other three subgroups. Conclusion Further studies for exploring the underlying pathophysiology and adjustment in the marker levels for screening of Down syndrome are warranted in pregnancies conceived after assisted reproduction. Copyright © 2005 John Wiley & Sons, Ltd.

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