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Hum. Reprod. Advance Access originally published online on May 19, 2005
Human Reproduction 2005 20(9):2623-2627; doi:10.1093/humrep/dei107
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions{at}oupjournals.org

First trimester biochemical screening for Down's syndrome in singleton pregnancies conceived by assisted reproduction

José Bellver1,2,3, Coral Lara1, Sergio R. Soares2, Alberto Ramírez2, Antonio Pellicer2, José Remohí2 and Vicente Serra1

1 Unidad de Medicina Materno-Fetal and 2 Unidad de Reproducción, Instituto Universitario IVI, Universidad de Valencia, Valencia, Spain

3 To whom correspondence should be addressed at: Instituto Valenciano de Infertilidad (IVI), Plaza de la Policía Local, 3, Valencia 46015, Spain. Email: jbellver{at}ivi.es

BACKGROUND: Serum biochemical markers [free {beta}hCG (f{beta}hCG); pregnancy-associated plasma protein-A (PAPP-A)] used in first trimester Down's syndrome screening have not been fully investigated in pregnancies achieved by assisted reproduction techniques. We present data on pregnancies conceived by all types of assisted reproduction techniques, including pregnancies following ovum donation (OD) and a large sample by ICSI. METHODS: First trimester Down's syndrome screening was performed in 1054 normal singleton pregnancies: natural conception (n=498), ovulation induction (OS, n=97), IVF (n=47), ICSI (n=222) and OD (n=190). RESULTS: No differences in maternal levels of f{beta}hCG and PAPP-A, measured by the Kryptor system, appeared between naturally conceived pregnancies (n=498) and those obtained with assisted reproduction techniques (n=556). Several differences were apparent when comparing f{beta}hCG levels between different technologies but PAPP-A levels only differed between OS and IVF pregnancies (P<0.05). In a further small study, no differences were observed using frozen embryos (n=37), preimplantation genetic diagnosis (n=53) or sperm from testicular biopsy (n=21). CONCLUSIONS: Data accumulated so far suggest that first trimester biochemical markers either do not need any adjustments (e.g. in pregnancies obtained after OS and ICSI), or have very little impact (e.g. IVF pregnancies) or no impact (e.g. OD pregnancies) on the false positive rates.

Key words: assisted reproduction/Down's syndrome screening/first trimester/free {beta}hCG/pregnancy-associated plasma protein-A


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D.J. Amor, J.X. Xu, J.L. Halliday, I. Francis, D.L. Healy, S. Breheny, H.W.G. Baker, and A.M. Jaques
Pregnancies conceived using assisted reproductive technologies (ART) have low levels of pregnancy-associated plasma protein-A (PAPP-A) leading to a high rate of false-positive results in first trimester screening for Down syndrome
Hum. Reprod., June 1, 2009; 24(6): 1330 - 1338.
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