دوره 23، شماره 3 - ( 12-1403 )                   جلد 23 شماره 3 صفحات 240-225 | برگشت به فهرست نسخه ها


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Meamar F Z, Savabi-Esfahani M, Farajkhoda T. Prenatal screening of Down syndrome in assisted reproductive techniques pregnancies: A systematic review. IJRM 2025; 23 (3) :225-240
URL: http://ijrm.ir/article-1-3424-fa.html
غربالگریهای پیش از تولد سندروم داون در بارداریهای حاصل از فنآوریهای کمکباروری: یک مرور سیستماتیک. International Journal of Reproductive BioMedicine. 1403; 23 (3) :225-240

URL: http://ijrm.ir/article-1-3424-fa.html


چکیده:   (41 مشاهده)
مقدمه: تفسیر نتایج غربالگری‌‌‌های سندروم داون در بارداری‌های حاصل از فن­آوری­های کمک­باروری چالش‌برانگیز است. با وجود بار روانی زیادی که نتایج مثبت کاذب در والدین ایجاد می‌کند، مطالعاتی که به نحوه‌ی تفسیر هر دو مارکر سرمی و سونوگرافیک در هر دو نوبت غربالگری تشخیص سندروم داون در بارداری‌های پس از فن­آوری­های کمک­باروری (ART) پرداخته‌اند، محدود است.
هدف: هدف این مطالعه­ی مروری، بررسی انواع غربالگری‌های سرمی و تصویربرداری تشخیص پیش از تولد سندروم داون در بارداری‌های حاصل از ART جهت تفسیر درست نتایج غربالگری­های قبل از تولد در این بارداری­ها می‌باشد.
مواد و روش­ ها: پایگاه‌های PubMed، Web of Science، Scopus، SID و موتور جست‌و‌جوی Google Scholar بدون محدودیت زمانی تاJanuary 2024 با استفاده از کلمات کلیدی جست‌و‌جو شد. فرآیند استخراج مقالات از دستورالعمل PRISMA، چک لیست STROBE و CONSORT استفاده شد.
نتایج: این مرور سیستماتیک با بررسی 30 مطالعه نشان می‌دهد که در غربالگری نوبت اول، پروتئین پلاسما مرتبط با بارداری (PAPP-A) به‌طور قابل توجهی نسبت به مقادیر نرمال، کمتر از حاملگی‌های خود‌به‌خودی است در حالی که گنادوتروپین آزاد جفتی انسانی (fβ-hCG) به‌خصوص در روش لقاح                 آزمایشگاهی (IVF) و تزریق داخل سیتوپلاسمی اسپرم (ICSI) به‌طور قابل توجهی بالاتر است. بعضی از مطالعات نیز حکایت از افزایش شفافیت نوکال (NT) در سه ماهه‌ی اول بارداری‌های حاصل از ART دارد. در مورد نشانگرهای بیوشمیایی غربالگری نوبت دوم سندروم داون نیز در بعضی از مطالعات، افزایش Inhibin-A، کاهش آلفافیتوپروتوئین (AFP) و استریول غیرکونژوگه (UE3) نسبت به مقادیر نرمال مشهود است.
نتیجه­ گیری: ممکن است دلایل تفاوت در سطوح نشانگرها، وجود هورمون­های محرک تخمک­گذاری، وجود چند جسم زرد، دو یا چندقلویی، نوع روش IVF و تغییرات در سیتوپلاسم تخمک در روش ICSI باشد. بنابراین به‌نظر می‌رسد به منظور بهینه‌سازی عملکرد تست‌های غربالگری، غلظت مارکرهای سرمی مادر به ویژه fβ-hCG و PAPP-A برای هر روش ART بهتر است متفاوت تنظیم شود.
نوع مطالعه: Review article |

فهرست منابع
1. Pendina AA, Efimova OA, Chiryaeva OG, Tikhonov AV, Petrova LI, Dudkina VS, et al. A comparative cytogenetic study of miscarriages after IVF and natural conception in women aged under and over 35 years. J Assist Reprod Genet 2014; 31: 149-155. [DOI:10.1007/s10815-013-0148-1] [PMID] [PMCID]
2. Fonseca A, Nazaré B, Canavarro MC. Parental psychological distress and quality of life after a prenatal or postnatal diagnosis of congenital anomaly: A controlled comparison study with parents of healthy infants. Disabil Health J 2012; 5: 67-74. [DOI:10.1016/j.dhjo.2011.11.001] [PMID]
3. Nakić Radoš S, Košec V, Gall V. The psychological effects of prenatal diagnostic procedures: Maternal anxiety before and after invasive and noninvasive procedures. Prenat Diagn 2013; 33: 1194-1200. [DOI:10.1002/pd.4223] [PMID]
4. Anckaert E, Schiettecatte J, Sleurs E, Devroey P, Smitz J. First trimester screening for Down's syndrome after assisted reproductive technology: Non-male factor infertility is associated with elevated free beta-human chorionic gonadotropin levels at 10-14 weeks of gestation. Fertil Steril 2008; 90: 1206-1210. [DOI:10.1016/j.fertnstert.2007.08.050] [PMID]
5. Nicolaides KH. Screening for fetal aneuploidies at 11 to 13 weeks. Prenat Diagn 2011; 31: 7-15. [DOI:10.1002/pd.2637] [PMID]
6. Hui P-W. Markers of Down syndrome and fetal growth profile in pregnancies conceived with assisted reproduction. [M.D. Thesis]. Hong Kong: University of Hong Kong, Pokfulam; 2014.
7. Ranjbar F, Warmelink JC, Mousavi R, Gharacheh M. Maternal-fetal attachment and anxiety in pregnant women who conceived through assisted reproductive technology: A longitudinal study. Int J Reprod BioMed 2021; 19: 1075-1084. [DOI:10.18502/ijrm.v19i12.10058] [PMID] [PMCID]
8. Darwiche J, Lawrence C, Vial Y, Wunder D, Stiefel F, Germond M, et al. Anxiety and psychological stress before prenatal screening in first-time mothers who conceived through IVF/ICSI or spontaneously. Women Health 2014; 54: 474-485. [DOI:10.1080/03630242.2014.897677] [PMID]
9. Geipel A, Berg C, Katalinic A, Ludwig M, Germer U, Diedrich K, et al. Different preferences for prenatal diagnosis in pregnancies following assisted reproduction versus spontaneous conception. Reprod Biomed Online 2004; 8: 119-124. [DOI:10.1016/S1472-6483(10)60506-8] [PMID]
10. Allyse M, Minear MA, Berson E, Sridhar S, Rote M, Hung A, et al. Non-invasive prenatal testing: A review of international implementation and challenges. Int J Women's Health 2015; 7: 113-126. [DOI:10.2147/IJWH.S67124] [PMID] [PMCID]
11. Akrami SM, Parvin Kh, Razmjoo M. [Legal review of fetal health screening and medical abortion in the population rejuvenation plan and family support]. Medical Law Journal 2021; 15: 505-516. (In Persian)
12. Cleary-Goldman J, Berkowitz RL. First trimester screening for Down syndrome in multiple pregnancy. Semin Perinatol 2005; 29: 395-400. [DOI:10.1053/j.semperi.2006.01.002] [PMID]
13. Greenhalgh T, Peacock R. Effectiveness and efficiency of search methods in systematic reviews of complex evidence: Audit of primary sources. BMJ 2005; 331: 1064-1065. [DOI:10.1136/bmj.38636.593461.68] [PMID] [PMCID]
14. Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. Int J Surg 2014; 12: 1495-1499. [DOI:10.1016/j.ijsu.2014.07.013] [PMID]
15. Faramarzi M, Pasha H, Esmailzadeh S, Kheirkhah F, Heidary S, Afshar Z. The effect of the cognitive behavioral therapy and pharmacotherapy on infertility stress: A randomized controlled trial. Int J Fertil Steril 2013; 7: 199-206.
16. Amor DJ, Xu JX, Halliday JL, Francis I, Healy DL, Breheny S, et al. Pregnancies conceived using assisted reproductive technologies (ART) have low levels of pregnancy-associated plasma protein-A (PAPP-A) leading to a high rate of false-positive results in first trimester screening for Down syndrome. Hum Reprod 2009; 24: 1330-1338. [DOI:10.1093/humrep/dep046] [PMID]
17. Bellver J, Lara C, Soares SR, Ramírez A, Pellicer A, Remohí J, et al. First trimester biochemical screening for Down's syndrome in singleton pregnancies conceived by assisted reproduction. Hum Reprod 2005; 20: 2623-2627. [DOI:10.1093/humrep/dei107] [PMID]
18. Bonnin A, Muller F, Senat MV, Sault C, Galland A, Taieb J, et al. Down syndrome maternal serum markers in oocyte donation and other assisted reproductive technologies. Prenat Diagn 2017; 37: 1155-1159. [DOI:10.1002/pd.5157] [PMID]
19. Hsu TY, Ou CY, Hsu JJ, Kung FT, Chang SY, Soong YK. Maternal serum screening for down syndrome in pregnancies conceived by intra-uterine insemination. Prenat Diagn 1999; 19: 1012-1014. https://doi.org/10.1002/(SICI)1097-0223(199911)19:11<1012::AID-PD688>3.0.CO;2-0 [DOI:10.1002/(SICI)1097-0223(199911)19:113.0.CO;2-0]
20. Hui PW, Lam YH, Tang MHY, Ng EHY, Yeung WSB, Ho PC. Maternal serum pregnancy-associated plasma protein-A and free beta-human chorionic gonadotrophin in pregnancies conceived with fresh and frozen-thawed embryos from in vitro fertilization and intracytoplasmic sperm injection. Prenat Diagn 2005; 25: 390-393. [DOI:10.1002/pd.1169] [PMID]
21. Lambert-Messerlian G, Dugoff L, Vidaver J, Canick JA, Malone FD, Ball RH, et al. First- and second-trimester Down syndrome screening markers in pregnancies achieved through assisted reproductive technologies (ART): A FASTER trial study. Prenat Diagn 2006; 26: 672-678. [DOI:10.1002/pd.1469] [PMID]
22. Liao AW, Heath V, Kametas N, Spencer K, Nicolaides KH. First-trimester screening for trisomy 21 in singleton pregnancies achieved by assisted reproduction. Hum Reprod 2001; 16: 1501-1504. [DOI:10.1093/humrep/16.7.1501] [PMID]
23. Matilainen M, Peuhkurinen S, Laitinen P, Jarvela I, Morin-Papunen L, Ryynanen M. In combined first-trimester Down syndrome screening, the false-positive rate is not higher in pregnancies conceived after assisted reproduction compared with spontaneous pregnancies. Fertil Steril 2011; 95: 378-381. [DOI:10.1016/j.fertnstert.2010.07.1048] [PMID]
24. Maymon R, Shulman A. Integrated first- and second-trimester Down syndrome screening test among unaffected IVF pregnancies. Prenat Diagn 2004; 24: 125-129. [DOI:10.1002/pd.809] [PMID]
25. Taheripanah R, Talayeh M, Zamaniyan M, Khosravi D, Taheripanah A. Comparison of first trimester screening for Down's syndrome using free beta-human chorionic gonadotropin and pregnancy-associated plasma protein-A levels between spontaneous and IVF pregnancies at 12 weeks of gestation. Int J Fertil Steril 2019; 13: 93-96.
26. Tul N, Novak-Antolic Z. Serum PAPP-A levels at 10-14 weeks of gestation are altered in women after assisted conception. Prenat Diagn 2006; 26: 1206-1211. [DOI:10.1002/pd.1589] [PMID]
27. Bender F, Hecken J, Reinsberg J, Berg C, van der Ven H, Gembruch U, et al. Altered first-trimester screening markers after IVF/ICSI: No relationship with small-for-gestational-age and number of embryos transferred. Reprod Biomed Online 2010; 20: 516-522. [DOI:10.1016/j.rbmo.2009.12.025] [PMID]
28. Bonne S, Sauleau E, Sananes N, Akaladios C, Rongières C, Pirrello O. Influence of medically assisted reproduction techniques on crown-rump length and biochemical markers of trisomy 21 in the first trimester of pregnancy. Fertil Steril 2016; 105: 410-416. [DOI:10.1016/j.fertnstert.2015.10.031] [PMID]
29. Sahraravand M, Laitinen P, Järvelä I, Ryynänen M. First‐trimester maternal serum ADAM12‐s and PAPP‐A levels are altered in pregnancies conceived after assisted reproduction techniques (ART). Prenat Diagn 2016; 36: 163-169. [DOI:10.1002/pd.4764] [PMID]
30. Savasi VM, Mandia L, Laoreti A, Ghisoni L, Duca P, Cetin I. First trimester placental markers in oocyte donation pregnancies. Placenta 2015; 36: 921-925. [DOI:10.1016/j.placenta.2015.06.009] [PMID]
31. Lai TH, Chen SC, Tsai MS, Lee FK, Wei CF. First-trimester screening for Down syndrome in singleton pregnancies achieved by intrauterine insemination. J Assist Reprod Genet 2003; 20: 327-331. [DOI:10.1023/A:1024813708875] [PMID] [PMCID]
32. Costa J-M, Letourneau A, Favre R, Bidat L, Belaisch-Allart J, Jouannic J-M, et al. Cell-free fetal DNA versus maternal serum screening for trisomy 21 in pregnant women with and without assisted reproduction technology: A prospective interventional study. Genet Med 2018; 20: 1346-1353. [DOI:10.1038/gim.2018.4] [PMID]
33. Yang C, Hu L, Jiang S, Liang F, Zhang S. Analysis of the impact of noninvasive prenatal testing for trisomies 21 and 18 in twin pregnancies undergoing artificial reproductive technology. Medicine (Baltimore) 2022; 101: e29985. [DOI:10.1097/MD.0000000000029985] [PMID] [PMCID]
34. Barkai G, Goldman B, Ries L, Chaki R, Dor J, Cuckle H. Down's syndrome screening marker levels following assisted reproduction. Prenat Diagn 1996; 16: 1111-1114. https://doi.org/10.1002/(SICI)1097-0223(199612)16:12<1111::AID-PD998>3.0.CO;2-X [DOI:10.1002/(SICI)1097-0223(199612)16:123.0.CO;2-X]
35. Räty R, Virtanen A, Koskinen P, Anttila L, Forsström J, Laitinen P, et al. Serum free beta-HCG and alpha-fetoprotein levels in IVF, ICSI and frozen embryo transfer pregnancies in maternal mid-trimester serum screening for Down's syndrome. Hum Reprod 2002; 17: 481-484. [DOI:10.1093/humrep/17.2.481] [PMID]
36. Pastorino D, Canini S, Prefumo F, Buffi D, Pugliese M, Venturini PL, et al. Stepwise sequential screening for trisomy 21 in assisted reproduction pregnancies. J Matern Fetal Neonatal Med 2009; 22: 1194-1196. [DOI:10.3109/14767050903067337] [PMID]
37. Lambert-Messerlian G, Kloza EM, Williams J, Loucky J, O'Brien B, Wilkins-Haug L, et al. Maternal plasma DNA testing for aneuploidy in pregnancies achieved by assisted reproductive technologies. Genet Med 2014; 16: 419-422. [DOI:10.1038/gim.2013.149] [PMID]
38. Räty R, Virtanen A, Koskinen P, Laitinen P, Forsström J, Salonen R, et al. Maternal midtrimester serum AFP and free beta-hCG levels in in vitro fertilization twin pregnancies. Prenat Diagn 2000; 20: 221-223. https://doi.org/10.1002/(SICI)1097-0223(200003)20:3<221::AID-PD787>3.0.CO;2-S [DOI:10.1002/(SICI)1097-0223(200003)20:33.0.CO;2-S]
39. Muller F, Dreux S, Lemeur A, Sault C, Desgrès J, Bernard MA, et al. Medically assisted reproduction and second‐trimester maternal serum marker screening for Down syndrome. Prenatal Diagn 2003; 23: 1073-1076. https://doi.org/10.1002/pd.594 [DOI:10.1002/pd.756] [PMID]
40. Oktem O, Barut T, Palaoglu E, Urman B. Uncomplicated singleton pregnancies conceived spontaneously and through assisted reproduction technologies (ART) have comparable first trimester screening profiles for Down syndrome. Fertil Steril 2010; 94: S27. [DOI:10.1016/j.fertnstert.2010.07.103]
41. Rice JD, McIntosh SF, Halstead AC. Second‐trimester maternal serum screening for Down syndrome in in vitro fertilization pregnancies. Prenat Diagn 2005; 25: 234-238. [DOI:10.1002/pd.1116] [PMID]
42. Gjerris AC, Loft A, Pinborg A, Christiansen M, Tabor A. Prenatal testing among women pregnant after assisted reproductive techniques in Denmark 1995-2000: A national cohort study. Hum Reprod 2008; 23: 1545-1552. [DOI:10.1093/humrep/den103] [PMID]
43. Lee TJ, Rolnik DL, Menezes MA, McLennan AC, da Silva Costa F. Cell-free fetal DNA testing in singleton IVF conceptions. Hum Reprod 2018; 33: 572-578. [DOI:10.1093/humrep/dey033] [PMID]
44. Muller F, Dreux S, Lemeur A, Sault C, Desgrès J, Bernard M-A, et al. Medically assisted reproduction and second-trimester maternal serum marker screening for Down syndrome. Prenat Diagn 2003; 23: 1073-1076. https://doi.org/10.1002/pd.594 [DOI:10.1002/pd.756]
45. Rice JD, McIntosh SF, Halstead AC. Second-trimester maternal serum screening for Down syndrome in in vitro fertilization pregnancies. Prenat Diagn 2005; 25: 234-238. [DOI:10.1002/pd.1116] [PMID]
46. Ben-Ami I, Maymon R, Svirsky R, Cuckle H, Jauniaux E. Down syndrome screening in assisted conception twins: An iatrogenic medical challenge. Obstet Gynecol Surv 2013; 68: 764-773. [DOI:10.1097/OGX.0000000000000001]
47. Sánchez-Pavón E, Mendoza H, García-Ferreyra J. Trisomy 21 and assisted reproductive technologies: A review. JBRA Assist Reprod 2022; 26: 129-141. [DOI:10.5935/1518-0557.20210047] [PMID] [PMCID]
48. Gregg AR, Skotko BG, Benkendorf JL, Monaghan KG, Bajaj K, Best RG, et al. Noninvasive prenatal screening for fetal aneuploidy, 2016 update: A position statement of the American College of Medical Genetics and Genomics. Genet Med 2016; 18: 1056-1065. [DOI:10.1038/gim.2016.97] [PMID]
49. Geipel A, Gembruch U, Ludwig M, Germer U, Schwinger E, Dormeier A, et al. Genetic sonography as the preferred option of prenatal diagnosis in patients with pregnancies following intracytoplasmic sperm injection. Hum Reprod 1999; 14: 2629-2634. [DOI:10.1093/humrep/14.10.2629] [PMID]
50. Pinborg A, Loft A, Rasmussen S, Schmidt L, Langhoff‐Roos J, Greisen G, et al. Neonatal outcome in a Danish national cohort of 3438 IVF/ICSI and 10 362 non‐IVF/ICSI twins born between 1995 and 2000. Hum Reprod 2004; 19: 435-441. [DOI:10.1093/humrep/deh063] [PMID]
51. Smith GCS, Crossley JA, Aitken DA, Pell JP, Cameron AD, Connor JM, et al. First-trimester placentation and the risk of antepartum stillbirth. JAMA 2004; 292: 2249-2254. [DOI:10.1001/jama.292.18.2249] [PMID]
52. Van Ravenswaaij R, Tesselaar‐Van der Goot M, de Wolf S, van Leeuwen‐Spruijt M, Visser GHA, Schielen PCJI. First‐trimester serum PAPP‐A and fβ‐hCG concentrations and other maternal characteristics to establish logistic regression‐based predictive rules for adverse pregnancy outcome. Prenat Diagn 2011; 31: 50-57. [DOI:10.1002/pd.2610] [PMID]
53. Nicolaides KH. A model for a new pyramid of prenatal care based on the 11 to 13 weeks' assessment. Prenat Diagn 2011; 31: 3-6. [DOI:10.1002/pd.2685] [PMID]
54. Smith-Bindman R, Hosmer W, Feldstein VA, Deeks JJ, Goldberg JD. Second-trimester ultrasound to detect fetuses with Down syndrome: A meta-analysis. JAMA 2001; 285: 1044-1055. [DOI:10.1001/jama.285.8.1044] [PMID]
55. Cavoretto P, Giorgione V, Cipriani S, Viganò P, Candiani M, Inversetti A, et al. Nuchal translucency measurement, free β-hCG and PAPP-A concentrations in IVF/ICSI pregnancies: Systematic review and meta-analysis. Prenat Diagn 2017; 37: 540-555. [DOI:10.1002/pd.5052] [PMID]

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