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Hum. Reprod. Advance Access originally published online on March 3, 2008
Human Reproduction 2008 23(5):1107-1112; doi:10.1093/humrep/den062
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© The Author 2008. 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@oxfordjournals.org

Does confined placental mosaicism account for adverse perinatal outcomes in IVF pregnancies?

B.C. Jacod1,5, K.D. Lichtenbelt2, G.H. Schuring-Blom2, J.S.E. Laven3, D. van Opstal4, M.J.C. Eijkemans1, N.S. Macklon on behalf of the IVF-CPM Study Group1,{dagger}

1 Department of Reproductive Medicine and Gynaecology, University Medical Centre, Utrecht, The Netherlands 2 Department of Clinical Genetics, University Medical Centre, Utrecht, The Netherlands 3 Department of Obstetrics and Gynaecology, Erasmus Medical Centre, Rotterdam, The Netherlands 4 Department of Clinical Genetics, Erasmus Medical Centre, Rotterdam, The Netherlands

5 Correspondence address. E-mail: b.c.jacod{at}students.uu.nl

BACKGROUND: IVF singletons have poorer perinatal outcomes than singletons from spontaneous conceptions. This may be due to the influence of ovarian stimulation on the chromosomal constitution of the embryos which could be translated into localized chromosomal anomalies in the placenta. The aim of this study was to compare the incidence of confined placental mosaicism (CPM) in IVF/ICSI pregnancies and spontaneous conceptions.

METHODS: We conducted a multi-centre retrospective analysis of karyotype results obtained by chorionic villus sampling (CVS), performed due to advanced maternal age (≥36 years at 18 weeks of gestation), in the Netherlands between 1995 and 2005.

RESULTS: From a total of 322 246 pregnancies, 20 885 CVS results were analysed: 235 in the IVF/ICSI group and 20 650 in the control group. The mean age of women in both groups was 38.4 years (mean difference –0.08, 95% CI –0.35 to 0.18). Data relating to the fetal karyotype were missing in 143 cases in the control group. When taking into account missing data, the incidence of CPM was lower in the IVF–ICSI group than in the control group, 1.3% versus 2.2% (odds ratio 0.59, 95% CI 0.19–1.85), whereas the incidence of fetal chromosomal anomalies was increased 4.3% versus 2.4% (odds ratio 1.81, 95% CI 0.95–3.42). Neither differences were statistically significant.

CONCLUSIONS: The incidence of CPM is not increased in IVF/ICSI pregnancies compared with spontaneous conceptions. CPM probably does not account for the adverse perinatal outcomes following IVF/ICSI.

Key words: IVF/CPM/perinatal outcomes/CVS/preimplantation genetic screening

{dagger} IVF – CPM Study Group: R.S.G.M. Bots (Department of Obstetrics and Gynaecology, St Elisabeth Hospital, Tilburg, The Netherlands), B.J. Cohlen (Department of Gynaecology, Isala Hospital, Zwolle, The Netherlands), P. van Dop (Department of Obstetrics and Gynaecology, Catharina Hospital, Eindhoven, The Netherlands), B.H.V. Faas (Department of Clinical Genetics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands), M. Goddijn (Centre for Reproductive Medicine, Department of Obstetrics and Gynaecology, Amsterdam Medical Centre, Amsterdam, The Netherlands), M.J.V. Hoffer (Department of Clinical Genetics, Leiden University Medical Centre, Leiden, The Netherlands), W.G. van Inzen (Department of Obstetrics and Gynaecology, Erasmus Medical Centre, Rotterdam, The Netherlands), A.C. Knegt (Department of Clinical Genetics, Amsterdam Medical Centre, Amsterdam, The Netherlands), J.A.M. Kremer (Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands), J.A. Land (Department of Obstetrics and Gynaecology, Ùniversity Medical Centre Groningen, Groningen, The Netherlands), M.V.E. Macville (Department of Clinical Genetics, Academic Hospital Masstricht, Maastricht, The Netherlands), N. Muntjewerff (Department of Obstetrics and Gynaecology, Academic Hospital Masstricht, Maastricht, The Netherlands), A.W.M. Nieuwint (Department of Clinical Genetics, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands), R. Schats (Department of Obstetrics and Gynaecology, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands), B. Sikkema-Raddatz (Department of Clinical Genetics, Ùniversity Medical Centre Groningen, Groningen, The Netherlands), H.J. Verburg (Department of Obstetrics and Gynaecology, Leiden University Medical Centre, Leiden, The Netherlands).

Submitted on August 28, 2007; resubmitted on December 20, 2007; accepted on January 7, 2008.


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