Top

Journal of Assisted Reproduction and Genetics

Published in:

01-05-2020 | Premature Birth | Assisted Reproduction Technologies

Placental histopathology in IVF pregnancies resulting from the transfer of frozen-thawed embryos compared with fresh embryos

Authors: Yossi Mizrachi, Ariel Weissman, Gili Buchnik Fater, Maya Torem, Eran Horowitz, Letizia Schreiber, Arieh Raziel, Jacob Bar, Michal Kovo

Published in: Journal of Assisted Reproduction and Genetics | Issue 5/2020

Abstract

Purpose

To study whether placentas of singleton pregnancies conceived after fresh embryo transfer (ET) contain more histopathological lesions compared with placentas of singleton pregnancies conceived after frozen-thawed embryo transfer (FET).

Methods

A prospective cohort study of placental histopathology in 131 women with singleton IVF pregnancies who delivered at a single medical center, between December 2017 and May 2019. The prevalence of different placental histopathology lesions was compared between women who conceived after fresh ET and FET.

Results

Women who conceived after fresh ET (n = 74) did not differ from women who conceived after FET (n = 57) with regard to maternal age, BMI, nulliparity, or infertility diagnosis. Gestational week at delivery was lower in pregnancies conceived after fresh ET (38.5 vs. 39.2 weeks, respectively, p = 0.04), and a trend for a lower birthweight following fresh ET was noted (3040 vs. 3216 g, respectively, p = 0.053). However, placental histopathology analysis from pregnancies conceived after fresh ET was comparable to pregnancies conceived after FET, with regard to the prevalence of maternal vascular malperfusion lesions (45.9% vs. 50.9%, respectively, p = 0.57), fetal vascular malperfusion lesions (17.6% vs. 21.1, p = 0.61), acute inflammatory response lesions (28.4% vs. 28.1%, respectively, p = 0.96), and chronic inflammatory response lesions (13.5% vs. 8.8%, respectively, p = 0.48).

Conclusion

Placental histopathology did not differ between IVF pregnancies conceived after fresh and frozen ET. These results are reassuring for clinicians and patients who wish to pursue with transferring fresh embryos.

Rienzi L, Gracia C, Maggiulli R, LaBarbera AR, Kaser DJ, Ubaldi FM, et al. Oocyte, embryo and blastocyst cryopreservation in ART: systematic review and meta-analysis comparing slow-freezing versus vitrification to produce evidence for the development of global guidance. Hum Reprod Update. 2017;23(2):139–55. https://doi.org/10.1093/humupd/dmw038.CrossRefPubMed

De Geyter C, Calhaz-Jorge C, Kupka MS, Wyns C, Mocanu E, Motrenko T, et al. ART in Europe, 2014: results generated from European registries by ESHRE†: the European IVF-monitoring Consortium (EIM)‡ for the European Society of Human Reproduction and Embryology (ESHRE). Hum Reprod. 2018;33(9):1586–601. https://doi.org/10.1093/humrep/dey242.CrossRefPubMed

Kushnir VA, Barad DH, Albertini DF, Darmon SK, Gleicher N. Systematic review of worldwide trends in assisted reproductive technology 2004–2013. Reprod Biol Endocrinol. 2017;15(1):6. https://doi.org/10.1186/s12958-016-0225-2.CrossRefPubMedPubMedCentral

Maheshwari A, Pandey S, Shetty A, Hamilton M, Bhattacharya S. Obstetric and perinatal outcomes in singleton pregnancies resulting from the transfer of frozen thawed versus fresh embryos generated through in vitro fertilization treatment: a systematic review and meta-analysis. Fertil Steril. 2012;98(2):368–77.e1–9. https://doi.org/10.1016/j.fertnstert.2012.05.019.CrossRefPubMed

Maheshwari A, Pandey S, Amalraj Raja E, Shetty A, Hamilton M, Bhattacharya S. Is frozen embryo transfer better for mothers and babies? Can cumulative meta-analysis provide a definitive answer? Hum Reprod Update. 2018;24(1):35–58. https://doi.org/10.1093/humupd/dmx031.CrossRefPubMed

Zhao J, Xu B, Zhang Q, Li YP. Which one has a better obstetric and perinatal outcome in singleton pregnancy, IVF/ICSI or FET?: a systematic review and meta-analysis. Reprod Biol Endocrinol. 2016;14(1):51. https://doi.org/10.1186/s12958-016-0188-3.CrossRefPubMedPubMedCentral

Beltran Anzola A, Pauly V, Montjean D, Meddeb L, Geoffroy-Siraudin C, Sambuc R, et al. No difference in congenital anomalies prevalence irrespective of insemination methods and freezing procedure: cohort study over fourteen years of an ART population in the south of France. J Assist Reprod Genet. 2017;34(7):867–76. https://doi.org/10.1007/s10815-017-0903-9.CrossRefPubMedPubMedCentral

Johnson KM, Hacker MR, Resetkova N, O'Brien B, Modest AM. Risk of ischemic placental disease in fresh and frozen embryo transfer cycles. Fertil Steril. 2019;111(4):714–21. https://doi.org/10.1016/j.fertnstert.2018.11.043.CrossRefPubMedPubMedCentral

von Versen-Hoynck F, Schaub AM, Chi YY, Chiu KH, Liu J, Lingis M, et al. Increased preeclampsia risk and reduced aortic compliance with in vitro fertilization cycles in the absence of a corpus luteum. Hypertension. 2019;73(3):640–9. https://doi.org/10.1161/hypertensionaha.118.12043.CrossRef

10.

Conrad KP, Petersen JW, Chi YY, Zhai X, Li M, Chiu KH, et al. Maternal cardiovascular dysregulation during early pregnancy after in vitro fertilization cycles in the absence of a corpus luteum. Hypertension. 2019;74(3):705–15. https://doi.org/10.1161/hypertensionaha.119.13015.CrossRefPubMed

11.

Brosens I, Pijnenborg R, Vercruysse L, Romero R. The “great obstetrical syndromes” are associated with disorders of deep placentation. Am J Obstet Gynecol. 2011;204(3):193–201. https://doi.org/10.1016/j.ajog.2010.08.009.CrossRefPubMed

12.

Khong Y, Brosens I. Defective deep placentation. Best Pract Res Clin Obstet Gynaecol. 2011;25(3):301–11. https://doi.org/10.1016/j.bpobgyn.2010.10.012.CrossRefPubMed

13.

Weiner E, Dekalo A, Feldstein O, Barber E, Schreiber L, Bar J, et al. The placental factor in spontaneous preterm birth in twin vs. singleton pregnancies. European journal of obstetrics, gynecology, and reproductive biology. 2017;214:1–5. https://doi.org/10.1016/j.ejogrb.2017.04.035.

14.

Kovo M, Schreiber L, Ben-Haroush A, Asalee L, Seadia S, Golan A, et al. The placental factor in spontaneous preterm labor with and without premature rupture of membranes. J Perinat Med. 2011;39(4):423–9. https://doi.org/10.1515/jpm.2011.038.CrossRefPubMed

15.

Catov JM, Scifres CM, Caritis SN, Bertolet M, Larkin J, Parks WT. Neonatal outcomes following preterm birth classified according to placental features. Am J Obstet Gynecol. 2017;216(4):411.e1–411.e14. https://doi.org/10.1016/j.ajog.2016.12.022.CrossRef

16.

Levy M, Kovo M, Schreiber L, Kleiner I, Grinstein E, Koren L, et al. Pregnancy outcomes in correlation with placental histopathology in subsequent pregnancies complicated by fetal growth restriction. Placenta. 2019;80:36–41. https://doi.org/10.1016/j.placenta.2019.04.001.CrossRefPubMed

17.

Weiner E, Mizrachi Y, Grinstein E, Feldstein O, Rymer-Haskel N, Juravel E, et al. The role of placental histopathological lesions in predicting recurrence of preeclampsia. Prenat Diagn. 2016;36(10):953–60. https://doi.org/10.1002/pd.4918.CrossRefPubMed

18.

Weiner E, Feldstein O, Tamayev L, Grinstein E, Barber E, Bar J, et al. Placental histopathological lesions in correlation with neonatal outcome in preeclampsia with and without severe features. Pregnancy Hypertens. 2018;12:6–10. https://doi.org/10.1016/j.preghy.2018.02.001.CrossRefPubMed

19.

Stanek J. Histological features of shallow placental implantation unify early-onset and late-onset preeclampsia. Pediatr Dev Pathol. 2019;22(2):112–22. https://doi.org/10.1177/1093526618803759.CrossRefPubMed

20.

Daniel Y, Schreiber L, Geva E, Amit A, Pausner D, Kupferminc MJ, et al. Do placentae of term singleton pregnancies obtained by assisted reproductive technologies differ from those of spontaneously conceived pregnancies? Hum Reprod. 1999;14(4):1107–10. https://doi.org/10.1093/humrep/14.4.1107.CrossRefPubMed

21.

Sacha CR, Harris AL, James K, Basnet K, Freret TS, Yeh J, et al. Placental pathology in live births conceived with in vitro fertilization after fresh and frozen embryo transfer. Am J Obstet Gynecol. 2019. https://doi.org/10.1016/j.ajog.2019.09.047.

22.

Khong TY, Mooney EE, Ariel I, Balmus NC, Boyd TK, Brundler MA, et al. Sampling and definitions of placental lesions: Amsterdam placental workshop group consensus statement. Arch Pathol Lab Med. 2016;140(7):698–713. https://doi.org/10.5858/arpa.2015-0225-CC.CrossRefPubMed

23.

Levy M, Mizrachi Y, Leytes S, Weiner E, Bar J, Schreiber L, et al. Can placental histopathology lesions predict recurrence of small for gestational age neonates? Reprod Sci. 2018;25:1485 1933719117749757. https://doi.org/10.1177/1933719117749757.CrossRefPubMed

24.

Weiner E, Barber E, Feldstein O, Schreiber L, Dekalo A, Mizrachi Y, et al. The placental component and neonatal outcome in singleton vs twin pregnancies complicated by gestational diabetes mellitus. Placenta. 2018;63:39–44. https://doi.org/10.1016/j.placenta.2018.01.010.CrossRefPubMed

25.

Ganer Herman H, Miremberg H, Schreiber L, Bar J, Kovo M. The association between disproportionate birth weight to placental weight ratio, clinical outcome, and placental histopathological lesions. Fetal Diagn Ther. 2017;41(4):300–6. https://doi.org/10.1159/000448949.CrossRefPubMed

26.

Chen ZJ, Shi Y, Sun Y, Zhang B, Liang X, Cao Y, et al. Fresh versus frozen embryos for infertility in the polycystic ovary syndrome. N Engl J Med. 2016;375(6):523–33. https://doi.org/10.1056/NEJMoa1513873.CrossRefPubMed

27.

Shi Y, Sun Y, Hao C, Zhang H, Wei D, Zhang Y, et al. Transfer of fresh versus frozen embryos in ovulatory women. N Engl J Med. 2018;378(2):126–36. https://doi.org/10.1056/NEJMoa1705334.CrossRefPubMed

28.

Hendrix MLE, Bons JAP, Alers NO, Severens-Rijvers CAH, Spaanderman MEA, Al-Nasiry S. Maternal vascular malformation in the placenta is an indicator for fetal growth restriction irrespective of neonatal birthweight. Placenta. 2019;87:8–15. https://doi.org/10.1016/j.placenta.2019.09.003.CrossRefPubMed

29.

Falco ML, Sivanathan J, Laoreti A, Thilaganathan B, Khalil A. Placental histopathology associated with pre-eclampsia: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2017;50(3):295–301. https://doi.org/10.1002/uog.17494.CrossRefPubMed

30.

Kovo M, Schreiber L, Ben-Haroush A, Cohen G, Weiner E, Golan A, et al. The placental factor in early- and late-onset normotensive fetal growth restriction. Placenta. 2013;34(4):320–4. https://doi.org/10.1016/j.placenta.2012.11.010.CrossRefPubMed

31.

Mizrachi Y, Barber E, Torem M, Tairy D, Weiner E, Bar J, et al. Is there a role for placental histopathology in predicting the recurrence of preterm birth? Arch Gynecol Obstet. 2019;300(4):917–23. https://doi.org/10.1007/s00404-019-05266-x.CrossRefPubMed

32.

Haavaldsen C, Tanbo T, Eskild A. Placental weight in singleton pregnancies with and without assisted reproductive technology: a population study of 536,567 pregnancies. Hum Reprod. 2012;27(2):576–82. https://doi.org/10.1093/humrep/der428.CrossRefPubMed

33.

Ginstrom Ernstad E, Wennerholm UB, Khatibi A, Petzold M, Bergh C. Neonatal and maternal outcome after frozen embryo transfer: increased risks in programmed cycles. Am J Obstet Gynecol. 2019. https://doi.org/10.1016/j.ajog.2019.03.010.

34.

von Versen-Hoynck F, Narasimhan P, Selamet Tierney ES, Martinez N, Conrad KP, Baker VL, et al. Absent or excessive corpus luteum number is associated with altered maternal vascular health in early pregnancy. Hypertension. 2019;73(3):680–90. https://doi.org/10.1161/hypertensionaha.118.12046.CrossRef

35.

Weinerman R, Ord T, Bartolomei MS, Coutifaris C, Mainigi M. The superovulated environment, independent of embryo vitrification, results in low birthweight in a mouse model. Biol Reprod. 2017;97(1):133–42. https://doi.org/10.1093/biolre/iox067.CrossRefPubMedPubMedCentral

36.

Hiura H, Hattori H, Kobayashi N, Okae H, Chiba H, Miyauchi N, et al. Genome-wide microRNA expression profiling in placentae from frozen-thawed blastocyst transfer. Clin Epigenetics. 2017;9:79. https://doi.org/10.1186/s13148-017-0379-6.CrossRefPubMedPubMedCentral

37.

Senapati S, Wang F, Ord T, Coutifaris C, Feng R, Mainigi M. Superovulation alters the expression of endometrial genes critical to tissue remodeling and placentation. J Assist Reprod Genet. 2018;35(10):1799–808. https://doi.org/10.1007/s10815-018-1244-z.CrossRefPubMedPubMedCentral

Title: Placental histopathology in IVF pregnancies resulting from the transfer of frozen-thawed embryos compared with fresh embryos
Authors: Yossi Mizrachi
Ariel Weissman
Gili Buchnik Fater
Maya Torem
Eran Horowitz
Letizia Schreiber
Arieh Raziel
Jacob Bar
Michal Kovo
Publication date: 01-05-2020
Publisher: Springer US
Keywords: Premature Birth
Pathology
Pre-Eclampsia
Published in: Journal of Assisted Reproduction and Genetics / Issue 5/2020
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI: https://doi.org/10.1007/s10815-020-01741-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Placental histopathology in IVF pregnancies resulting from the transfer of frozen-thawed embryos compared with fresh embryos

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 5/2020

All roads lead to Rome: the many ways to pluripotency

Efficacy of MLPA for detection of Y-chromosome microdeletions in infertile Brazilian patients

Early pregnancy loss: the default outcome for fertilized human oocytes

Do serum progesterone levels on day of embryo transfer influence pregnancy outcomes in artificial frozen-thaw cycles?

The role and mechanism of asymmetric dimethylarginine in fetal growth restriction via interference with endothelial function and angiogenesis

Correction to: Early pregnancy loss: the default outcome for fertilized human oocytes