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Mode of conception does not appear to affect placental volume in the first trimester

  • Sara J. Churchill
    Affiliations
    Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, California
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  • Erica T. Wang
    Affiliations
    Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, California

    David Geffen School of Medicine, University of California, Los Angeles, California
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  • Marcy Akhlaghpour
    Affiliations
    Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, California
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  • Ellen H. Goldstein
    Affiliations
    Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, California

    David Geffen School of Medicine, University of California, Los Angeles, California
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  • Dina Eschevarria
    Affiliations
    David Geffen School of Medicine, University of California, Los Angeles, California
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  • Naomi Greene
    Affiliations
    David Geffen School of Medicine, University of California, Los Angeles, California
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  • Matthew Macer
    Affiliations
    Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, California

    David Geffen School of Medicine, University of California, Los Angeles, California
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  • Temeka Zore
    Affiliations
    Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, California

    David Geffen School of Medicine, University of California, Los Angeles, California
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  • John Williams III
    Affiliations
    David Geffen School of Medicine, University of California, Los Angeles, California

    Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Cedars-Sinai Medical Center, Los Angeles, California
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  • Margareta D. Pisarska
    Correspondence
    Reprint requests: Margareta D. Pisarska, M.D., Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, 8635 West Third Street, Suite 160W, Los Angeles, California 90048.
    Affiliations
    Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Cedars-Sinai Medical Center, Los Angeles, California

    David Geffen School of Medicine, University of California, Los Angeles, California
    Search for articles by this author

      Objective

      To study whether infertility treatments, including IVF and non-IVF fertility treatments, are associated with diseases of placental insufficiency in early gestation. First trimester placental volumes by ultrasound and chorionic villi weight during sampling (CVS) were performed to detect differences between pregnancies conceived spontaneously versus with fertility treatments.

      Design

      Retrospective cohort.

      Setting

      Academic tertiary center.

      Patient(s)

      Women with singleton pregnancies undergoing CVS and first trimester ultrasound from April 2007 to November 2015.

      Intervention(s)

      Estimated placental volume (EPV) was calculated from ultrasound images using a validated computation and CVS estimated tissue weight was performed using a validated visual analogue scale.

      Main Outcome Measure(s)

      Adjusted linear regression was used to compare EPV and CVS weight based on mode of conception.

      Result(s)

      A total of 1,977 spontaneous and 334 conceived with fertility treatments (133 non-IVF and 201 IVF) pregnancies were included. Significant differences in maternal age, gravidity, hypertension, and smoking status were identified. EPV and CVS weight were correlated with maternal age, gestational age, and maternal hypertension. Adjusted linear regression showed no difference in EPV in pregnancies conceived with fertility treatments versus spontaneously. The CVS weight was significantly lower in the IVF conceptions in unadjusted univariate analyses. However, after adjusted regression, this was no longer significant.

      Conclusion(s)

      Mode of conception does not appear to affect first trimester placental size. As differences in maternal age, hypertension, and smoking status differ among the groups and are correlated to placental size, it may be the underlying patient population leading to abnormal placentation and insufficiency, not the fertility treatments used.

      Key Words

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