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The impact of progesterone use on the first trimester combined screening test
Zafer Bütün1, Gökalp Şenol2, Kamuran Suman3, Ahu Korkut Orta4, Vehbi Yavuz Tokgöz5, Melih Velipaşaoğlu5, Hüseyin Mete Tanır5, Ahmet Başar Tekin51Department of Perinatology, Private Clinic, Eskisehir, Turkey2Department of Perinatology, Hitit University, Erol Olcok Training and Research Hospital, Corum, Turkey
3Department of Perinatology, Afyonkarahisar Hospital, Afyonkarahisar, Turkey
4Department of Perinatology, Antalya City Hospital, Antalya, Turkey
5Department of Perinatology, Eskisehir Osmangazi University, Eskisehir, Turkey
INTRODUCTION: This study aimed to investigate the impact of luteal phase progesterone supplementation in in vitro fertilization (IVF) pregnancies on the parameters and results of the first-trimester combined screening test.
METHODS: A retrospective study involving 230 pregnant women was conducted, including 91 IVF pregnancies and 139 spontaneously conceived pregnancies. The analysis focused on maternal age, levels of pregnancy-associated plasma protein-A (PAPP-A), uterine vascular resistance, and outcomes from the first-trimester combined screening test.
RESULTS: The IVF group had a significantly higher maternal age, averaging 34.5 years (±4.2) compared to 30.1 years (±4.5) in the spontaneously conceived group (p<0.001). PAPP-A levels were lower in the IVF group, with an average of 0.88 MoM (±0.32) compared to 1.05 MoM (±0.20) in the spontaneously conceived group (p<0.01). Uterine vascular resistance, measured via Doppler ultrasound, was significantly higher in IVF pregnancies, averaging 0.63 (±0.15) compared to 0.54 (±0.12) in the spontaneously conceived group (p<0.05). Importantly, there were no significant differences in the overall results of the first-trimester combined screening test, with detection rates for aneuploidies of 85.1% in the IVF group versus 87.3% in the spontaneously conceived group (p=0.45), and false positive rates of 5.2% versus 5.8%, respectively (p=0.68).
DISCUSSION AND CONCLUSION: While pregnancies achieved through IVF may exhibit increased uterine vascular resistance (11%) and alterations in PAPP-A levels (17% lower), these variations do not lead to significant differences in the outcomes of first-trimester combined screening tests. The combined screening test remains a reliable tool for risk assessment in both IVF and naturally conceived pregnancies, supporting its continued use in clinical practice. Future studies may explore the long-term implications of these biochemical and hemodynamic changes in IVF pregnancies.
Manuscript Language: English
