Geburtshilfe Frauenheilkd 2018; 78(10): 177
DOI: 10.1055/s-0038-1671288
Poster
Freitag, 02.11.2018
Endokrinologie und Reproduktionsmedizin II
Georg Thieme Verlag KG Stuttgart · New York

Aberrant corpus luteum number is associated with altered maternal vascular health in early pregnancy – a contributor to increased preeclampsia risk after assisted reproduction?

F von Versen-Höynck
1   Stanford University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Sunnyvale, Vereinigte Staaten von Amerika
2   Medizinische Hochschule Hannover, Frauenklinik, Hannover, Deutschland
,
P Narasimhan
3   Stanford University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive, Stem Cell and Perinatal Biology, Stanford, Vereinigte Staaten von Amerika
,
ES Selamet Tierney
4   Lucile Packard Children's Hospital, Department of Pediatrics, Division of Pediatric Cardiology, Stanford, Vereinigte Staaten von Amerika
,
N Martinez
3   Stanford University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive, Stem Cell and Perinatal Biology, Stanford, Vereinigte Staaten von Amerika
,
KP Conrad
5   Departments of Physiology and Functional Genomics and Obstetrics and Gynecology, D. H. Barron Reproductive and Perinatal Biology Research Program, University of Florida College of Medicine, Gainesville, Vereinigte Staaten von Amerika
,
VL Baker
1   Stanford University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Sunnyvale, Vereinigte Staaten von Amerika
,
VD Winn
3   Stanford University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive, Stem Cell and Perinatal Biology, Stanford, Vereinigte Staaten von Amerika
› Author Affiliations
Further Information

Publication History

Publication Date:
20 September 2018 (online)

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Objective:

Assisted reproduction is associated with an increased risk for preeclampsia but the reasons are mainly unstudied. We determined if a non-physiologic hormonal milieu influenced by the number of corpora lutea (CL) and the mode of conception affect maternal vascular health in early pregnancy.

Methods:

In a prospective cohort of women at 11 to 14 weeks' gestation (N = 57) blood pressure, endothelial function, circulating endothelial progenitor cell (CPC) numbers, lipids, and CL hormones were compared by number of CL and mode of conception: 0 CL (programmed frozen embryo transfer (FET)); 1 CL (spontaneous pregnancy after infertility or modified natural cycle FET); or > 3 CL associated with in-vitro fertilization.

Results:

Women with 0 or > 3 CL lacked the drop in mean arterial blood pressure compared to women with one CL (P= 0.05; P= 0.05). Reactive Hyperemia Index (RHI) was impaired in patients lacking a CL compared to 1 CL (P= 0.04). Baseline pulse wave amplitude was higher in subjects with > 3 CL compared to 1 CL (P= 0.01) or 0 CL (P= 0.01). Suppression of CL development in programmed FET cycles was associated with a lower RHI compared with FETs in a natural cycle (P= 0.03). Angiogenic and non-angiogenic CPC numbers were lower in the absence of a CL in FETs (P= 0.02 and P= 0.04). Relaxin levels correlated with the number of angiogenic CPCs (r = 0.31; P= 0.03).

Summary:

Maternal vascular health in early pregnancy is altered in women with aberrant numbers of CL, and might represent insufficient cardiovascular adaptation contributing to an increased risk of preeclampsia.