The impact of progesterone use on the first trimester combined screening test

Bütün Z., Şenol G., Suman K., Korkut Orta A., TOKGÖZ V. Y., VELİPAŞAOĞLU M., ...More

Zeynep Kamil Medical Journal, vol.56, no.1, pp.23-26, 2025 (Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 56 Issue: 1
  • Publication Date: 2025
  • Doi Number: 10.14744/zkmj.2024.46504
  • Journal Name: Zeynep Kamil Medical Journal
  • Journal Indexes: Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.23-26
  • Keywords: Beta-human chorionic gonadotropin (β-hCG), first-trimester combined screening test, in vitro fertilization, nuchal translucency, pregnancy-associated plasma protein-A (PAPP-A), progesterone supplementation
  • Eskisehir Osmangazi University Affiliated: Yes

Abstract

Objective: This study aimed to investigate the impact of luteal phase progesterone supplementation in in vitro fertilization (IVF) pregnancies on the parameters and results of the first-trimester combined screening test. Material and Methods: A retrospective study involving 230 pregnant women was conducted, including 91 IVF pregnancies and 139 spontaneously conceived pregnancies. The analysis focused on maternal age, levels of pregnancy-associated plasma protein-A (PAPP-A), uterine vascular resistance, and outcomes from the first-trimester combined screening test. Results: The IVF group had a significantly higher maternal age, averaging 34.5 years (±4.2) compared to 30.1 years (±4.5) in the spontaneously conceived group (p<0.001). PAPP-A levels were lower in the IVF group, with an average of 0.88 MoM (±0.32) compared to 1.05 MoM (±0.20) in the spontaneously conceived group (p<0.01). Uterine vascular resistance, measured via Doppler ultrasound, was significantly higher in IVF pregnancies, averaging 0.63 (±0.15) compared to 0.54 (±0.12) in the spontaneously conceived group (p<0.05). Importantly, there were no significant differences in the overall results of the first-trimester combined screening test, with detection rates for aneuploidies of 85.1% in the IVF group versus 87.3% in the spontaneously conceived group (p=0.45), and false positive rates of 5.2% versus 5.8%, respectively (p=0.68). Conclusion: While pregnancies achieved through IVF may exhibit increased uterine vascular resistance (11%) and alterations in PAPP-A levels (17% lower), these variations do not lead to significant differences in the outcomes of first-trimester combined screening tests. The combined screening test remains a reliable tool for risk assessment in both IVF and naturally conceived pregnancies, supporting its continued use in clinical practice. Future studies may explore the long-term implications of these biochemical and hemodynamic changes in IVF pregnancies.