Key result
ICSI linked to greater fetal cardiac remodeling versus spontaneous conception, especially with fresh embryo transfers.
Why the study?
Because pregnancies conceived via ICSI are associated with higher fetal cardiac remodeling risk, this study evaluated whether the type of embryo transfer affects the magnitude of remodeling.
Does the type of embryo transfer (fresh vs frozen) affect fetal cardiac remodeling in pregnancies conceived via ICSI compared to spontaneous conception?
Cross-Sectional (n=332)
Does the type of embryo transfer (fresh vs frozen) affect fetal cardiac remodeling in pregnancies conceived via ICSI compared to spontaneous conception?
p-value: p=< 0.0001
Pregnancies conceived by ICSI, particularly those using fresh embryos, are associated with a higher degree of fetal cardiac remodeling compared to spontaneous conception.
Fresh embryo transfer in ICSI pregnancies associates with greater fetal cardiac remodeling than frozen; leaves open clinical relevance and need for prospective outcome studies.
OBJECTIVE: Pregnancies conceived via intracytoplasmic sperm injection (ICSI) are associated with a higher risk of fetal cardiac remodeling. The aim of this study was to evaluate whether the type of embryo transfer may affect the magnitude of fetal cardiac remodeling in pregnancies conceived via ICSI. METHODS: Prospective cross-sectional study including 212 pregnancies conceived by ICSI (111 with frozen and 101 with fresh embryos) and 120 spontaneously conceived gestations. All women underwent ultrasound biometric evaluation, Doppler, and echocardiographic assessment, including evaluation of left and right atrial areas and sphericity index (SI), at 20-24 weeks of gestation. The χ2 and Kruskal-Wallis H tests were used to analyze the data. RESULTS: There was no difference in maternal characteristics, gestational age at ultrasound, Doppler, and fetal weight among the study groups. In pregnancies conceived by ICSI, left and right atrial areas were higher (p < 0.0001) and SI was lower (p < 0.0001) compared to spontaneously conceived pregnancies. Left (p = 0.004) and right (p = 0.023) atrial areas and left (p = 0.036) and right (p = 0.002) SIs were more affected in ICSI pregnancies conceived by fresh embryos. CONCLUSION: The risk of fetal cardiac remodeling is higher in pregnancies conceived by ICSI and independent from fetal size and Doppler. The magnitude of these changes is affected by the type of ICSI technique and is higher in pregnancies conceived by fresh embryos.
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Rizzo et al. (2020) conducted a cross-sectional in Pregnancies conceived by ICSI (n=332). Intracytoplasmic sperm injection (ICSI) with fresh or frozen embryos vs. Spontaneously conceived pregnancies was evaluated on Fetal cardiac remodeling (left and right atrial areas and sphericity index) (p=< 0.0001). Pregnancies conceived by ICSI showed greater fetal cardiac remodeling (higher atrial areas and lower sphericity index, p<0.0001) than spontaneous pregnancies, especially with fresh embryo transfers.
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