#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Limits of preeclampsia screening and prevention in a population of women after assisted reproductive technologies


Authors: M. Michna 1,2;  K. Balasičová 1,3;  S. Toporcerová 1,3
Authors‘ workplace: Centrum asistovanej reprodukcie, Gyncare a. s., Košice, Slovenská republika 1;  Gynekologicko-pôrodnícka klinika LF UPJŠ a FN AGEL Košice-Šaca a. s., Slovenská republika 2;  Gynekologicko-pôrodnícka klinika LF UPJŠ a UN L. Pasteura, Košice, Slovenská republika 3
Published in: Ceska Gynekol 2026; 91(2): 142-147
Category:
doi: https://doi.org/10.48095/cccg2026142

Overview

Pregnancies resulting from assisted reproductive technologies are associated with an increased risk of developing preeclampsia. Available data indicate that one of the risk factors is frozen embryo transfer in an artificial cycle. Assessment of the pulsatility index of the uterine artery along with maternal factors and serum biomarkers form the basis for preeclampsia screening in the 1st trimester. Current evidence suggests that the method of endometrial preparation for embryo transfer may influence uterine artery pulsatility index values, thereby affecting the estimation of preeclampsia risk.

Keywords:

assisted reproduction – screening – preeclampsia – in vitro fertilisation – frozen embryo transfer – relaxin – corpus luteum


Sources

1. Roque M, Haahr T, Geber S et al. Fresh versus elective frozen embryo transfer in IVF/ICSI cycles: a systematic review and meta-analysis of reproductive outcomes. Hum Reprod Update 2019; 25 (1): 2–14. doi: 10.1093/humupd/ dmy033.

2. Bortoletto P, Prabhu M, Baker VL. Association between programmed frozen embryo transfer and hypertensive disorders of pregnancy. Fertil Steril 2022; 118 (5): 779–786. doi: 10.1016/ j.fertnstert.2022.07.025.

3. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol 2020; 135 (6): e237–e260. doi: 10.1097/AOG.0000000000003891.

4. Webster K, Fishburn S, Maresh M et al. Diagnosis and management of hypertension in pregnancy: summary of updated NICE guidance. BMJ 2019; 366: l5119. doi: 10.1136/bmj. l5119.

5. O’ Gorman N, Wright D, Poon LC et al. Multicenter screening for preeclampsia by maternal factors and biomarkers at 11-13 weeks’ gestation: comparison to NICE guidelines and ACOG recommendations. Ultrasound Obstet Gynecol 2017; 49 (6): 756–760. doi: 10.1002/uog.17455.

6. Rolnik DL, Wright D, Poon LC et al. ASPRE trial: performance of screening for preterm pre-eclampsia. Ultrasound Obstet Gynecol 2017; 50 (4): 492–495. doi: 10.1002/uog.18816.

7. Marshall SA, Senadheera SN, Parry LJ et al. The role of relaxin in normal and abnormal uterine function during the menstrual cycle and early pregnancy. Reprod Sci 2017; 24 (3): 342–354. doi: 10.1177/1933719116657189.

8. Post Uiterweer ED, Koster MP, Jeyabalan A et al. Circulating pregnancy hormone relaxin as a first trimester biomarker for preeclampsia. Pregnancy Hypertens 2020; 22 : 47–53. doi: 10.1016/j.preghy.2020.07.008.

9. Conrad KP, Graham GM, Chi YY et al. Potential influence of the corpus luteum on circulating reproductive and volume regulatory hormones, angiogenic and immunoregulatory factors in pregnant women. Am J Physiol Endocrinol Metab 2019; 317 (4): E677–E685. doi: 10.1152/ajpendo.00225.2019.

10. Wiegel RE, Jan Danser AH, Steegers-Theunissen RP et al. Determinants of maternal renin-angiotensin-aldosterone-system activation in early pregnancy: insights from 2 cohorts. J Clin Endocrinol Metab 2020; 105 (11): 3505–3517. doi: 10.1210/clinem/dgaa582.

11. Debrah DO, Novak J, Matthews JE et al. Relaxin is essential for systemic vasodilation and increased global arterial compliance during early pregnancy in conscious rats. Endocrinology 2006; 147 (11): 5126–5131. doi: 10.1210/en.2006-0567.

12. Hong K, Park HJ, H Cha D. Clinical implications of placenta-derived angiogenic/anti-angiogenic biomarkers in pre-eclampsia. Biomark Med 2021; 15 (7): 523–536. doi: 10.2217/bmm-2020-0545.

13. Moreno-Sepulveda J, Espinós JJ, Checa MA. Lower risk of adverse perinatal outcomes in natural versus articial frozen-thawed embryo transfer cycles: a systematic review and meta-analysis. Reprod Biomed Online 2021; 42 (6): 1131–1145. doi: 10.1016/j.rbmo.2021. 03.002.

14. Conrad KP, von Versen-Höynck F, Baker VL. Potential role of the corpus luteum in maternal cardiovascular adaptation to pregnancy and preeclampsia risk. Am J Obstet Gynecol 2022; 226 (5): 683–699. doi: 10. 1016/ j.ajog.2021.08.018.

15. Wang B, Zhang J, Zhu Q et al. Effects of different cycle regimens for frozen embryo transfer on perinatal outcomes of singletons. Hum Reprod 2020; 35 (7): 1612–1622. doi: 10.1093/humrep/deaa093.

16. Zaat TR, Kostova EB, Korsen P et al. Obstetric and neonatal outcomes after natural versus artificial cycle frozen embryo transfer and the role of luteal phase support: a systematic review and meta-analysis. Hum Reprod Update 2023; 29 (5): 634–654. doi: 10.1093/humupd/dmad011.

17. Donno V, Prats P, Rodriguez I et al. First-trimester uterine artery pulsatility index and preeclampsia risk in pregnancies after artificial frozen embryo transfer: analysis of over 27,000 pregnancies. Am J Obstet Gynecol 2025; 232 (5): 464.e1–464.e9. doi: 10.1016/j.ajog.2024.10.033.

18. Chang K, Zhang L. Review article: steroid hormones and uterine vascular adaptation to pregnancy. Reprod Sci 2008; 15 (4): 336–348. doi: 10.1177/1933719108317975.

19. Çintesun E, Çintesun FN, Mammadova N et al. The influence of vaginal progesterone on Uterine Artery Pulsatility Index. Ginekol Pol. doi: 10.5603/GP.a2020.0178. Online ahead of print.

20. Gooi JH, Richardson ML, Jelinic M et al. Enhanced uterine artery stiffness in aged pregnant relaxin mutant mice is reversed with exogenous relaxin treatment. Biol Reprod 2013; 89 (1): 18. doi: 10.1095/biolreprod.113. 108118.

Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

Article was published in

Czech Gynaecology

Issue 2

2026 Issue 2

Most read in this issue
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#