학술논문

Placental histology and pregnancy complications following intracytoplasmic sperm injection for non-male factor infertility
Document Type
Original Paper
Source
Journal of Assisted Reproduction and Genetics: An Official Journal of the American Society for Reproductive Medicine. 39(5):1135-1141
Subject
Intracytoplasmic sperm injection (ICSI)
In vitro fertilization (IVF)
Placenta
Villitis of unknown etiology
Placental calcification
Language
English
ISSN
1058-0468
1573-7330
Abstract
Abstract: Purpose: To assess obstetric outcomes and placental histology following intracytoplasmic sperm injection (ICSI), for non-male infertility.Methods: This was a retrospective cohort of live born singleton deliveries after in vitro fertilization (IVF) at a single university affiliated medical center between 2009 and 2017. Excluded were IVF cycles with male infertility and oocyte recipients. We compared obstetric outcomes and placental histology in cases ICSI was performed (ICSI group) and cases with no ICSI (IVF group).Results: A total of 400 deliveries following ICSI were compared to 218 in the IVF group. Maternal age was similar between the groups, while diminished ovarian reserve was more common among ICSI patients and tubal disease less common (p < 0.001). The rate of blastocyte transfer was also significantly lower in the ICSI group—67.5% vs. 77%, p = 0.01. Pregnancies following ICSI were characterized by similar rates of preeclampsia, preterm birth, and small for gestational age neonates. Although cesarean delivery rate was significantly higher in the group, this did no attain significance after adjustment for confounders. Placentas in the ICSI group were notable for a lower rate of villitis of unknown etiology (1% vs. 4.5%, p = 0.007) and a higher rate of maternal surface calcifications (33% vs. 23.8%, p = 0.01) after adjustment for confounders.Conclusion: The employment of ICSI with no male indication is associated with similar obstetric outcomes. Despite isolated placental differences among many investigated, placental histology seems overall comparable as well. These results are reassuring to clinicians and patients.