Maternal serum screening markers and nuchal translucency measurements in in vitro fertilization pregnancies: a systematic review.

OBJECTIVE: To study the current literature on the association between IVF treatment and maternal serum screening marker levels and nuchal translucency thickness.

DESIGN: Systematic review.

SETTINGS: Not applicable.

PATIENT(S): Eligible studies included those with an exposed group of pregnant women that used IVF with or without intracytoplasmic sperm injection to conceive and a control group of pregnant women who conceived spontaneously.

INTERVENTION(S): IVF treatment to conceive.

MAIN OUTCOME MEASURE(S): Outcomes evaluated included maternal serum screening markers (pregnancy-associated plasma protein A [PAPP-A], alpha-fetoprotein, hCG, unconjugated estriol, dimeric inhibin-A) and nuchal translucency thickness.

RESULT(S): Database searches identified 4,118 titles and abstracts that were independently screened, which resulted in 76 articles that were assessed for eligibility. Additionally, one study was added for consideration based on expert knowledge. There were 29 cohort and 11 case-control studies in the descriptive review. The most commonly reported markers were PAPP-A and free β-hCG, which were reported in 28 and 26 studies, respectively. The studies that reported effect sizes for PAPP-A and free β-hCG were not statistically significant.

CONCLUSION(S): A decrease in PAPP-A and an increase in total hCG was consistently reported among the included studies. However, owing to the variability in the levels of the other maternal serum screening markers reported and the inability to conduct a meta-analysis, we were unable to generalize about the differences between prenatal screening results in the IVF population.