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A study associates frozen embryos with a higher risk of maternal hypertension in pregnancy

2022-09-26T12:46:51.535Z


A study of 4.5 million women found that the risk was increased when frozen embryos were used for IVF.


By Kaitlin SullivanNBC

News

Undergoing IVF with frozen embryos is linked to an increased risk of high blood pressure disorders, including preeclampsia, during pregnancy, according to research published Monday in the journal Hypertension. 

Although the link between frozen embryo transfers and high blood pressure is not new, the research, which included data from millions of women in Norway, provides a clearer understanding of the risk.

The study is the largest to date to include data from women with multiple pregnancies.

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Overall, the risk of hypertensive disorders was low: about 7.4% in women who used frozen embryos, compared to 5.6% in those who used fresh embryos and 4.3% in those who conceived naturally. 

But when the researchers adjusted for other factors that could cause hypertensive disorders during pregnancy, such as age, existing hypertension, and obesity, they found that the risk was about 74% higher when using frozen embryos, compared with IVF. vitro with fresh embryos or a naturally conceived pregnancy.

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Furthermore, they found that there was no significant difference in risk between women who conceived naturally and those who underwent IVF with fresh embryos. 

About 75% of the women who developed hypertensive disorders in the study developed pre-eclampsia, characterized by severely elevated blood pressure along with signs of liver or kidney damage after the 20th week of pregnancy.

It can be fatal if left untreated.

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"If our study only found that there is an association only for isolated gestational hypertensive disorders, we would not be so concerned, but in our further analysis we found that there was a strong association between frozen IVF and pre-eclampsia," explained lead author of the study, Dr. Sindre Petersen, a doctoral fellow at the Norwegian University of Science and Technology.

Developing high blood pressure during pregnancy doesn't always lead to complications, but it's important for doctors to monitor these women closely for signs of preeclampsia.

According to the Centers for Disease Control and Prevention (CDC), about 1 in 12 women in the US have high blood pressure during pregnancy, and about 1 in 25 pregnant women develop high blood pressure. preeclampsia, according to the American Heart Association.

Ruth Gómez, specialist in reproductive medicine and head of the Mainz Fertility and EPI Center, stands next to a cryotank with frozen sperm and embryos at the University Hospital in Mainz, Germany, on January 28, 2020. Andreas Arnold / Picture Alliance via Getty Images

The new study looked at data on 4.5 million pregnancies in Norway from 1988 to 2015. The group included 4.4 million pregnancies conceived naturally and compared them with just over 78,000 IVF pregnancies conceived with a fresh embryo and some 18,000 with a frozen embryo.

About 33,000 of the pregnancies were in women who had more than one pregnancy. 

According to preliminary data from the CDC, nearly 80,000 babies born in the United States in 2020 were the result of assisted reproductive technology, which includes in vitro fertilization. 

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“The reality is that women are now older when they have their first pregnancy, so they are more likely to potentially need treatments like IVF, which could be more common in the future,” said Dr. Anum Minhas, cardio- an obstetrician at Johns Hopkins Medicine, who was also not involved in the new research.

It is not yet clear why the use of a frozen embryo increases a woman's risk of a hypertensive disorder, but one hypothesis is the absence of a temporary organ called the corpus luteum. 

When a woman ovulates, a follicle in her ovary releases an egg.

Soon after, that follicle develops a corpus luteum, which secretes the hormones needed in early pregnancy.

These include progesterone and relaxin, which work together to thicken the walls of the uterus and make it an ideal environment for the developing embryo. 

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“In artificial frozen transfers, the corpus luteum is omitted.

But on fresh transfers, it's still there,” says Petersen.

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An earlier study published in Hypertension in 2019 found that women who conceive without a corpus luteum are at increased risk of preeclampsia.

It also found that the risk of preeclampsia was elevated in women who had a frozen transfer, but not in those who received a fresh embryo during IVF. 

How an embryo develops may also influence high blood pressure disorders, explained Dr. Elizabeth Langen, co-director of the University of Michigan cardio-obstetrics program, who was not involved in the new research.

Embryo freezing could influence the development process, she said.

One of the limitations of the study is that it included mostly white participants.

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"It's not clear to what extent it applies to other countries, especially those with a lot of racial ethnic diversity," Minha said, adding that the increased risk for black women in the US and South Asian women in everyone could be even older. 

Petersen stressed that the overall risk of preeclampsia remains low and that the results of the new study should not scare women away from using frozen embryos.

Source: telemundo

All news articles on 2022-09-26

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