The Impact Of Assisted Reproductive Technology On Mid-trimester Screening Serum Markers Of The Down’s Syndrome

Objective1.The aim of this study was to compare the maternal mid-trimester free betahuman chorionic gonadotropin(β-hCG), alpha fetoprotein(AFP) and unconjuga-ted estriol (uE3) levels in pregnancies conceived by assisted reproduction techn-ology and spontaneous pregnancies in Downs syndrome screening. Then estim-ate whether fasle positive rates altered in ART.2.Through crowd serum markers of the lab research, determine the resear-ch groups all pregnant median level, to observe any differences with the softwa-re embedded value.MethodsFrom January2010through October2012, We selected TaiAnShi center ho-spital outpatient clinic of15to206weeks of eugenic and superior nurture singlepregnancy,2499cases of pregnant women, including357cases of pregnant wo-men through assisted reproductive technology conceived pregnancy,2142casesof naturally conceived pregnant women, each one ART pregnancy pregnant wo-men match the six natural pregnancy pregnant women (pregnant female age dif-fer<1year old, when screening for gestational age for the same gestational age).Find out two sets of obstetric complications, and pathological pregnancy preg-nant women, compared two groups the incidence of obstetric complications andpathological pregnancy. Rule out two sets of pathological pregnancy and pregn-ant women, obstetric complications compared with two groups of pregnant wo-men serum AFP, remaining beta hCG and uE3numerical values (expressed inmultiples of the median, MOM), and compare the two groups of false positiverate. Compare the median level of healthy naturally conceived population and software embedded value differences.Statistical processing: SPSS13.0software was used to statistical analysis,measurement data with mean±standard deviation, according to comparison bet-ween groups using single factor analysis of variance,t-test and rank and inspect-ion; Count data expressed as a percentage (%), rate of comparison with line bychi-square. Inspection level of alpha=0.05Results1.From January2010to October2012, in our hospital the median of β-hCGis15th week21.5ng/ml,16th week16.4ng/ml,17th week12.8ng/ml,18th week10.4ng/ml,19th week8.8ng/ml,20th week8.1ng/ml. the median of AFP:15thweek26.9klu/l,16th week30.3klu/l,17th week35.7klu/l,18th week40.4klu/l,19th week46.5klu/l,20th week50.8klu/l. the median of uE3:15th week1.96nmol/l,16th week2.20nmol/l,17th week2.81nmol/l,18th week3.42nmol/l,19th week4.26nmol/l,20th week5.12nmol/l.2.The β-hCG multiples of the median(MOM)values were statistically sign-ificantly elevated in ART group. Rule out pregnant women who have pregnancycomplications or the adverse pregnancy outcome, there is still a difference（P＜0.05）3.The AFP and uE3multiples of the median(MOM)values in ART pregna-ncies were lower than spontaneous pregnancies, but do not have statistical signi-ficance（P＞0.05）.4.Rule out pregnant women who have pregnancy complications or the adv-erse pregnancy outcome，The β-hCG multiples of the median(MOM)values werestatistically significantly in ICSI and IVF than IUI（P＜0.05）, AFP and uE3didnot have significant difference（P＞0.05）.5.Frozen embryo transplantation group had a significantly higher β-hCGthan fresh embryo transplantation group(P＜0.05）,AFP and uE3did not havesignificant difference（P＞0.05）.6.The embryo transfer number for two groups ofβ-hCG is significantly hig-her than a group(P＜0.05）, AFP and uE3did not have significant difference（P＞0.05）. 7.The fasle positive rate（FPR） in the Down syndrome screening inassisted reproductive technology pregnancies was slightly higher than thespontaneous pregnancies. but do not have statistical significance（P＞0.05）.Conclusions1.The median of β-hCG, AFP and uE3in this area didn’t have differencewith software embedded value.2.The β-hCG multiples of the median(MOM)values were statistically sign-ificantly elevated in ART group. Rule out pregnant women who have pregnancycomplications or the adverse pregnancy outcome, there is still a difference. AFPand uE3did not have significant difference3.The fasle positive rate（FPR）in the Down syndrome screening in assistedreproductive technology pregnancies was slightly higher than the spontaneouspregnancies. but do not have statistical significance3. Adverse pregnancy co m plications were more common in the ART pregn-ancies than in spontaneouspregnancies.