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Is artificial endometrial preparation more associated with early-onset or late-onset preeclampsia after frozen embryo transfer?

  • Assisted Reproduction Technologies
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Abstract

Purpose

To explore whether the risks of early- or late-onset preeclampsia vary among frozen embryo transfer (FET) with different regimens for endometrial preparation and fresh embryo transfer (FreET).

Methods

We retrospectively included a total of 24129 women who achieved singleton delivery during their first cycles of in vitro fertilization (IVF) between January 2012 and March 2020. The risks of early- and late-onset preeclampsia after FET with endometrial preparation by natural ovulation cycles (FET-NC) or by artificial cycles (FET-AC) were compared to that after FreET.

Results

After adjustment via multivariable logistic regression, the total risk of preeclampsia was higher in the FET-AC group compared to the FreET group [2.2% vs. 0.9%; adjusted odds ratio (aOR): 2.00; 95% confidence interval (CI): 1.45–2.76] and FET-NC group (2.2% vs. 0.9%; aOR: 2.17; 95% CI: 1.59–2.96).When stratified by the gestational age at delivery based on < 34 weeks or ≥ 34 weeks, the risk of late-onset preeclampsia remained higher in the FET-AC group than that in the and FreET group (1.8% vs. 0.6%; aOR: 2.56; 95% CI: 1.83–3.58) and the FET-NC group (1.8% vs. 0.6%; aOR: 2.63; 95% CI: 1.86–3.73). We did not find a statistically significant difference in the risk of early-onset preeclampsia among the three groups.

Conclusions

An artificial regimen for endometrial preparation was more associated with an increased risk of late-onset preeclampsia after FET. Given that FET-AC is widely used in clinical practice, the potential maternal risk factors for late-onset preeclampsia when using the FET-AC regimen should be further explored, considering the maternal origin of late-onset preeclampsia.

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Data availability

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Code availability

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Acknowledgements

The authors thank the patients and staff of the Center for Reproductive Medicine of Shandong University for their cooperation and support.

Funding

This work was supported by grants from the National Natural Science Foundation of China (82071718 and 82101784).

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Authors and Affiliations

  1. Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China

    Yue Niu, Lu Suo, Dingying Zhao, Yuhuan Wang, Ruolan Miao, Jialin Zou, Xinwei Han, Zi-Jiang Chen, Yan Li & Daimin Wei

  2. Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China

    Yue Niu, Lu Suo, Dingying Zhao, Yuhuan Wang, Ruolan Miao, Jialin Zou, Xinwei Han, Zi-Jiang Chen, Yan Li & Daimin Wei

  3. Medical Integration and Practice Center, Shandong University, No. 44 Wenhua Xi Rd, Jinan, 250012, Shandong, China

    Yue Niu, Lu Suo, Dingying Zhao, Yuhuan Wang, Ruolan Miao, Jialin Zou, Xinwei Han, Zi-Jiang Chen, Yan Li & Daimin Wei

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  1. Yue Niu
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Contributions

D.M.W., Y.L., and Z.J.C. supervised the entire study, including the procedures, conception, design, and completion; Y.N., L.S., and D.Y.Z. analyzed the data and drafted the manuscript; Y.N., L.S., D.Y.Z., Y.H.W., R.L.M., J.L.Z., and X.W.H. collected the data; D.M.W. and Y.L. revised the manuscript. All authors have been involved in interpreting the data and have approved the final version.

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Correspondence to Yan Li or Daimin Wei.

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All methods in this study were carried out in accordance with the guidelines and regulations in the Declaration of Helsinki. The Institutional Ethics Committee of the Center for Reproductive Medicine of Shandong University approved the study (Ethical Review No.04, 2022).

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Niu, Y., Suo, L., Zhao, D. et al. Is artificial endometrial preparation more associated with early-onset or late-onset preeclampsia after frozen embryo transfer?. J Assist Reprod Genet 40, 1045–1054 (2023). https://doi.org/10.1007/s10815-023-02785-0

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