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Human Reproduction, Vol. 18, No. 3, 572-575, March 2003
© 2003 European Society of Human Reproduction and Embryology

Maternal serum hCG and alpha-fetoprotein levels in pregnancies conceived after IVF or ICSI with fresh and frozen–thawed embryos

P.W. Hui1,5, M.H.Y. Tang2, Y.H. Lam3, E.H.Y. Ng4, W.S.B. Yeung4 and P.C. Ho4

1 Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong, 2 Prenatal Diagnostic and Counselling Department, Tsan Yuk Hospital, Hong Kong, 3 Hong Kong Prenatal Diagnosis Center, Hong Kong and 4 Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, China

5 To whom correspondence should be addressed at: 6/F, Professorial Block, Department of Obstetrics and Gynaecology, Queen Mary Hospital, 102 Pokfulam Road, Pokfulam, Hong Kong, China. e-mail: pwhui{at}hkusua.hku.hk

BACKGROUND: Studies have shown that levels of serum markers of Down’s syndrome were altered in pregnancies conceived after IVF, though the reason for this remains unknown. METHODS: Second-trimester maternal serum levels of hCG and alpha-fetoprotein (AFP) in pregnancies conceived with fresh and frozen–thawed embryos after assisted reproduction were compared with those conceived spontaneously. RESULTS: There were 203 pregnancies with fresh embryo transfers (130 IVF cases, 73 ICSI cases) and 98 pregnancies with frozen–thawed embryo transfers (61 IVF cases, 37 ICSI cases). The controls consisted of 17 145 spontaneous pregnancies. The median hCG multiples of the median (MoM) was significantly increased to 1.24 in 98 pregnancies conceived after frozen embryo transfer. This elevation was observed only in the IVF-frozen embryo transfer subgroup (P < 0.001), but not in the ICSI-frozen embryo transfer subgroup. The median AFP MoM for 203 pregnancies after fresh embryo transfer was 0.90. Among the subgroups, the median AFP MoM was significantly reduced to 0.90 and 0.86 in IVF-embryo transfer (P = 0.04) and ICSI-embryo transfer (P = 0.001) pregnancies respectively, and significantly raised to 1.20 in the IVF-frozen embryo transfer subgroup. CONCLUSIONS: The degree of alterations in maternal serum hCG and AFP levels varied between fresh and frozen–thawed embryos, and also between the mode of fertilization. Pregnancies resulting from ICSI or frozen embryo transfer should be regarded as distinct entities from those of IVF-embryo transfer.

Key words: alpha-fetoprotein/frozen–thawed embryo transfer/hCG/ICSI/IVF


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J. Bellver, C. Lara, S. R. Soares, A. Ramirez, A. Pellicer, J. Remohi, and V. Serra
First trimester biochemical screening for Down's syndrome in singleton pregnancies conceived by assisted reproduction
Hum. Reprod., September 1, 2005; 20(9): 2623 - 2627.
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