ASSISTED REPRODUCTION TECHNOLOGIES
First trimester pregnancy ultrasound findings as a function of method
of conception in an infertile population
Frauke von Versen-Höynck
1,2
&
Jenna S. Petersen
3
&
Yueh-Yun Chi
4
&
Jing Liu
4
&
Valerie L. Baker
1
Received: 19 November 2017 /Accepted: 5 January 2018 /Published online: 29 January 2018
#
Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract
Purpose The aim of this study was to determine whether first trimester ultrasound measurements of crown rump length (CRL)
and gestational sac diameter (GSD) differ depending on the method of conception among infertile women.
Method Infertile women, ages 21–50 years old, who conceived viable, singleton pregnancies via fresh embryo transfer (ET),
frozen ET, non-in vitro fertilization (IVF) fertility treatment, or spontaneously were included in this observational cohort study at
an academic fertility practice. Embryonic growth trajectories defined by the CRL and GSD at 6 and 8 weeks’ gestation were
analyzed and compared among the methods of conception.
Results Crown rump length at 6 weeks’ gestation was smaller for conceptions achieved via fresh ET compared with frozen ET in
a natural cycle (1.50 vs. 2.50 mm, p = 0.017). Crown rump length was smaller at 8 weeks’ gestation in conceptions achieved via
fresh ET compared to frozen ET in a programmed cycle (16.13 vs. 17.02 mm, p =0.039).
Conclusion Among infertile women, embryo growth may differ between fresh and frozen ET as early as 6 and 8 weeks’ gestation.
Keywords First trimester
.
Crown rump length
.
Gestational sac diameter
.
Embryo transfer
.
Assisted reproduction
Introduction
Pregnancies conceived via assisted reproductive technology
(ART) begin in a non-physiologic maternal endocrine milieu,
which is in part due to treatments that result in high numbers
of corpora lutea (CL) or the absence of CL [1]. The CL se-
cretes not only estradiol and progesterone but also other prod-
ucts such as relaxin which may influence placentation and
pregnancy development. Past studies have demonstrated that
ART is associated with an increased risk of certain adverse
fetal and maternal outcomes [2–4]. However, relatively few
studies have been published regarding fertility treatment and
first trimester embryonic growth [5–7], and the available pub-
lications have focused mostly on comparing pregnancies con-
ceived by autologous fresh IVF to spontaneous conceptions
among fertile women. None have examined first trimester
growth parameters specifically as a function of method of
conception.
There has been a trend towards increased utilization of
frozen-thawed ET after studies have suggested an impact of
the unphysiological environment of a fresh ET on pregnancy
outcomes [8, 9]. A large meta-analysis showed higher perina-
tal and maternal morbidity in women who conceived from
fresh ET compared to frozen ET [10]. The authors found
higher rates of antepartum hemorrhage, preterm birth, small
for gestational age, low birth weight, and perinatal mortality in
infants among women who received fresh embryos [10]. More
recent studies have again shown lower mean birth weights
The authors consider that the first two authors should be regarded as joint
First Authors.
Electronic supplementary material The online version of this article
(https://doi.org/10.1007/s10815-018-1120-x) contains supplementary
material, which is available to authorized users.
* Frauke von Versen-Höynck
frauke@stanford.edu
1
Stanford Medicine Fertility and Reproductive Health, Stanford
University School of Medicine, 1195 West Fremont Avenue, Suite
1301, Sunnyvale, CA 94087, USA
2
Department of Obstetrics and Gynecology, Hannover Medical
School, Carl-Neuberg-Str. 1, 30625 Hannover, Lower Saxony,
Germany
3
Department of Internal Medicine, Oregon Health and Science
University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239,
USA
4
Department of Biostatistics, University of Florida, 2004 Mowry
Road, Gainesville, FL 32611, USA
Journal of Assisted Reproduction and Genetics (2018) 35:863–870
https://doi.org/10.1007/s10815-018-1120-x
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