Human Reproduction, Vol. 17, No. 2, 481-484,
February 2002
© 2002 European Society of Human Reproduction and Embryology
Serum free ß-HCG and alpha-fetoprotein levels in IVF, ICSI and frozen embryo transfer pregnancies in maternal mid-trimester serum screening for Down's syndrome
1 Departments of Obstetrics and Gynaecology, 2 Central Laboratory, 3 Medical Informatics Research Centre in Turku (MIRCIT), University of Turku, Kiinamyllynkatu 4–8, FIN-20520 Turku, 4 Department of Central Laboratory and Rehabilitation Research Centre of the Social Insurance Institution, Peltolantie 3, FIN-20720 Turku, 5 The Family Federation of Finland, Maariankatu 3A, FIN-20100 Turku, 6 Central Laboratory, Oulu University Hospital, P.O.Box 22, 90221 Oulu, 7 Department of Central Laboratory, Tampere University Hospital, P.O.Box 2000, 33521 Tampere and 8 Department of Obstetrics and Gynaecology, University of Helsinki, Haartmaninkatu 2, P.O.X. 140, HUS, FIN-00029 Helsinki, Finland
BACKGROUND: The aim of this study was to compare the maternal mid-trimester free ß-HCG and alpha-fetoprotein (AFP) levels in pregnancies conceived by assisted reproduction technology and spontaneous pregnancies in Down's syndrome screening. The influence of the number of embryos transferred and the amount of gonadotrophins used on the marker levels was also evaluated. METHODS: The study population consisted of 58 IVF, 32 ICSI and 26 frozen embryo transfer (FET) singleton pregnancies. The levels of ß-HCG and AFP were compared with the control group of 6548 singleton spontaneous pregnancies. RESULTS: The false positive rate (FPR) in the Down's syndrome screening was 19% overall in assisted reproductive technology pregnancies, being highest (30.8%) in the FET group. The free ß-HCG multiples of the median (MoM) values were statistically significantly elevated only in the FET group (1.33 MoM; P = 0.012). A positive correlation between the number of embryos transferred and the marker levels was observed in the IVF group. No correlation was found between the amount of gonadotrophin medication used and the marker levels. CONCLUSIONS: The present data confirm that the overall FPR in the serum screening for Down's syndrome in assisted reproduction pregnancies is high, resulting in unnecessary invasive procedures.
Key words: AFP/ß-HCG/Down's syndrome/FET/ICSI/IVF
9 To whom correspondence should be addressed. E-mail: raija.raty{at}pp.inet.fi
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