154. Placental structure and vascularization in IVF/ICSI-pregnancies compared to naturally conceived pregnancies

Abstract

Objectives Although pregnancy rates of artificial reproductive techniques (ART) pregnancies have been optimized, these pregnancies have a higher risk of pregnancy complications due to impaired placentation during early pregnancy and thereby affecting placental vascularization, -structure and later on fetal growth. The aim of this study is to investigate if there are placental ultrasonographic differences between ART- and naturally conceived pregnancies. Methods A cross-sectional pilot study included 35 ART- and 30 naturally conceived (NC) pregnancies at the Maastricht University Medical Centre, between October 2017 and March 2018. Inclusion criteria were singleton pregnancies (NC, IVF/ICSI), maternal age ⩾18 years and body-mass-index (BMI) Results Placental calcifications at 12 and 16 weeks of gestation showed no significant difference between the ART and NC-group. However, placental lakes at 16 weeks were more prominent in the ART-group (59.5%) compared to the NC-group (26.1% (p = 0.017). Vascularization index at the umbilical cord insertion (UCI) and in the peripheral parts of the placenta was measured. At 12 weeks, the ART-group compared to the NC-group, showed a lower VI at the UCI (0.73 ± 0.81% vs. 2.00 ± 2.46%, p = 0.156) and in the peripheral parts of the placenta (1.73 ± 3.43% vs. 4.14 ± 4.92%, p = 0.023). At 16 weeks, no significant differences were found. Conclusions Reduced early placental vascularisation in ART-compared to NC-pregnancies may reflect the underlying aetiology of impaired placentation. These results provide promising possibilities for a more extended prospective trial and using placental ultrasonography as a predictor in the future.