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Kaya, N. S., Guven, E. S. G., & Guven, S. (2023). In vitro fertilization pregnancy may cause fetal thymic volume involution: A case-control study. International Journal of Reproductive BioMedicine (IJRM), 21(10), 819–826. https://doi.org/10.18502/ijrm.v21i10.14537
https://doi.org/10.18502/ijrm.v21i10.14537
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authors
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Nurgul Selin Kaya
Nurgul Selin Kaya
Departments of Obstetrics and Gynecology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
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Emine Seda Guvendag Guven
Emine Seda Guvendag Guven
Departments of Obstetrics and Gynecology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
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Suleyman Guven
Suleyman Guven
Departments of Obstetrics and Gynecology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Published Date
- Nov 21, 2023
In vitro fertilization pregnancy may cause fetal thymic volume involution: A case-control study
Abstract
Background: The effect of modern infertility treatment modalities on fetal thymic volume has not been well known.
Objective: 3-dimensional (3D) fetal thymus volumes of 18-24 wk in vitro fertilization (IVF) pregnancies and spontaneous pregnancy cases were compared.
Materials and Methods: 135 cases were evaluated in this prospective case-control study. The study was conducted between July 2019 and July 2020 at a university hospital in Trabzon, Turkey. Fetal thymus volume was calculated in the pregnant cases included in the study with the help of the virtual organ computer-assisted analysis system included in the advanced ultrasonography system. The fetal thymus volumes were compared between pregnant women with IVF and spontaneous pregnant women.
Results: The fetal thymus size was significantly lower in the IVF pregnancy group than in spontaneous pregnancy cases (p < 0.001). It was found that the fetal complications, such as non-reassuring fetal health status and requirement for neonatal intensive care, were higher in cases who became pregnant after IVF treatment. It was also found that the rate of any pregnancy complication was significantly higher in IVF pregnancy c group (p = 0.02).
Conclusion: In light of these results, it may be concluded that small fetal thymus size may be another fetal complication of IVF pregnancies.
Key words: Fetus, Fertilization in vitro, Prenatal ultrasonography, Thymus.
References
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[4] El-Chaar D, Yang Q, Gao J, Bottomley J, Leader A, Wen SW, et al. Risk of birth defects increased in pregnancies conceived by assisted human reproduction. Fertil Steril 2009; 92: 1557–1561.
[5] Reddy UM, Wapner RJ, Rebar RW, Tasca RJ. Infertility, assisted reproductive technology, and adverse pregnancy outcomes: Executive summary of a National Institute of Child Health and Human Development workshop. Obstet Gynecol 2007; 109: 967–977.
[6] Dumoulin JM, Coonen E, Bras M, Bergers-Janssen JM, Ignoul-Vanvuchelen RC, van Wissen LC, et al. Embryo development and chromosomal anomalies after ICSI: Effect of the injection procedure. Hum Reprod 2001; 16: 306–312.
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[8] Bloise E, Feuer SK, Rinaudo PF. Comparative intrauterine development and placental function of ART concepti: Implications for human reproductive medicine and animal breeding. Hum Reprod Update 2014; 20: 822–839.
[9] RoysterIV GD, Krishnamoorthy K, Csokmay JM, Yauger BJ, Chason RJ, DeCherney AH, et al. Are intracytoplasmic sperm injection and high serum estradiol compounding risk factors for adverse obstetric outcomes in assisted reproductive technology? Fertil Steril 2016; 106: 363–370.
[10] Choux C, Carmignac V, Bruno C, Sagot P, Vaiman D, Fauque P. The placenta: Phenotypic and epigenetic modifications induced by assisted reproductive technologies throughout pregnancy. Clin Epigenetics 2015; 7: 87.
[11] Sciaky-Tamir Y, Hershkovitz R, Mazor M, Shelef I, Erez O. The use of imaging technology in the assessment of the fetal inflammatory response syndrome- imaging of the fetal thymus. Prenatal Diagn 2015; 35: 413–419.
[12] Nau TG, de Murcia KO, Möllers M, Braun J, Abhari RE, Steinhard J, et al. Foetal thymus size in pregnancies after assisted reproductive technologies. Arch Gynecol Obstet 2018; 298: 329–336.
[13] Basaran OE, Guvendag Guven ES, Guven S. First trimester fetal thymus volume may predict preeclampsia. Pregnancy Hypertens 2021; 26: 116– 120.
[14] El-Haieg DO, Zidan AA, El-Nemr MM. The relationship between sonographic fetal thymus size and the components of the systemic fetal inflammatory response syndrome in women with preterm prelabour rupture of membranes. BJOG 2008; 115: 836–841.
[15] Musilova I, Hornychova H, Kostal M, Jacobsson B, Kacerovsky M. Ultrasound measurement of the transverse diameter of the fetal thymus in pregnancies complicated by the preterm prelabor rupture of membranes. J Clin Ultrasound 2013; 41: 283–289.
[16] Yinon Y, Zalel Y, Weisz B, Mazaki-Tovi S, Sivan E, Schiff E, et al. Fetal thymus size as a predictor of chorioamnionitis in women with preterm premature rupture of membranes. Ultrasound Obstet Gynecol 2007; 29: 639–643.
[17] Chaoui R, Heling KS, Lopez AS, Thiel G, Karl K. The thymic-thoracic ratio in fetal heart defects: A simple way to identify fetuses at high risk for microdeletion 22q11. Ultrasound Obstet Gynecol 2011; 37: 397–403.
[18] Gruver AL, Sempowski GD. Cytokines, leptin, and stress-induced thymic atrophy. J Leukocyte Biol 2008; 84: 915–923.
[19] Taub DD, Longo DL. Insights into thymic aging and regeneration. Immunol Rev 2005; 205: 72–93.
[20] Gruver AL, Sempowski GD. Cytokines, leptin, and stress-induced thymic atrophy. J Leukoc Biol 2008; 84: 915–923.
[21] Concordet JP, Ferry A. Physiological programmed cell death in thymocytes is induced by physical stress (exercise). Am J Physiol 1993; 265: C626–C629.
[22] De Felice C, Toti P, Santopietro R, Stumpo M, Pecciarini L, Bagnoli F. Small thymus in very low birth weight infants born to mothers with subclinical chorioamnionitis. J Pediatr 1999; 135: 384–386.
[23] McDade TW, Beck MA, Kuzawa CW, Adair LS. Prenatal undernutrition and postnatal growth are associated with adolescent thymic function. J Nutr 2001; 131: 1225– 1231.
[24] Ferguson AC. Prolonged impairment of cellular immunity in children with intrauterine growth retardation. J Pediatr 1978; 93: 52–56.
[25] Godfrey K, Barker D, Osmond C. Disproportionate fetal growth and raised IgE concentration in adult life. Clin Exp Allergy 1994; 24: 641–648.
[26] Borgelt JMA, Mollers M, Falkenberg MK, Amler S, Klockenbusch W, Schmitz R. Assessment of firsttrimester thymus size and correlation with maternal diseases and fetal outcome. Acta Obstet Gynecol Scand 2016; 95: 210–216.
[27] Dornemann R, Koch R, Möllmann U, Falkenberg MK, Möllers M, Klockenbusch W, et al. Fetal thymus size in pregnant women with diabetic diseases. J Perinat Med 2017; 45: 595–601.
[28] Li L, Bahtiyar MO, Buhimschi CS, Zou L, Zhou QC, Copel JA. Assessment of the fetal thymus by two- and three-dimensional ultrasound during normal human gestation and in fetuses with congenital heart defects. Ultrasound Obstet Gynecol 2011; 37: 404–409.
[29] Warby AC, Amler S, Jacobi AM, Hammer K, Mollmann U, Falkenberg MK, et al. Imaging of fetal thymus in pregnant women with rheumatic diseases. J Perinat Med 2014; 42: 635–639.
[30] Zalel Y, Gamzu R, Mashiach S, Achiron R. The development of the fetal thymus: An in utero sonographic evaluation. Prenat Diagn 2002; 22: 114–117.
[2] Kissin DM, Jamieson DJ, Barfield WD. Monitoring health outcomes of assisted reproductive technology. N Engl J Med 2014; 371: 91–93.
[3] Fauser BCJM, Devroey P, Diedrich K, Balaban B, Bonduelle M, Delemarre-Van De Waal H, et al. Health outcomes of children born after IVF/ICSI: A review of current expert opinion and literature. Reprod Biomed Online 2014; 28: 162–182.
[4] El-Chaar D, Yang Q, Gao J, Bottomley J, Leader A, Wen SW, et al. Risk of birth defects increased in pregnancies conceived by assisted human reproduction. Fertil Steril 2009; 92: 1557–1561.
[5] Reddy UM, Wapner RJ, Rebar RW, Tasca RJ. Infertility, assisted reproductive technology, and adverse pregnancy outcomes: Executive summary of a National Institute of Child Health and Human Development workshop. Obstet Gynecol 2007; 109: 967–977.
[6] Dumoulin JM, Coonen E, Bras M, Bergers-Janssen JM, Ignoul-Vanvuchelen RC, van Wissen LC, et al. Embryo development and chromosomal anomalies after ICSI: Effect of the injection procedure. Hum Reprod 2001; 16: 306–312.
[7] Hansen M, Kurinczuk JJ, Bower C, Webb S. The risk of major birth defects after intracytoplasmic sperm injection and in vitro fertilization. N Engl J Med 2002; 346: 725–730.
[8] Bloise E, Feuer SK, Rinaudo PF. Comparative intrauterine development and placental function of ART concepti: Implications for human reproductive medicine and animal breeding. Hum Reprod Update 2014; 20: 822–839.
[9] RoysterIV GD, Krishnamoorthy K, Csokmay JM, Yauger BJ, Chason RJ, DeCherney AH, et al. Are intracytoplasmic sperm injection and high serum estradiol compounding risk factors for adverse obstetric outcomes in assisted reproductive technology? Fertil Steril 2016; 106: 363–370.
[10] Choux C, Carmignac V, Bruno C, Sagot P, Vaiman D, Fauque P. The placenta: Phenotypic and epigenetic modifications induced by assisted reproductive technologies throughout pregnancy. Clin Epigenetics 2015; 7: 87.
[11] Sciaky-Tamir Y, Hershkovitz R, Mazor M, Shelef I, Erez O. The use of imaging technology in the assessment of the fetal inflammatory response syndrome- imaging of the fetal thymus. Prenatal Diagn 2015; 35: 413–419.
[12] Nau TG, de Murcia KO, Möllers M, Braun J, Abhari RE, Steinhard J, et al. Foetal thymus size in pregnancies after assisted reproductive technologies. Arch Gynecol Obstet 2018; 298: 329–336.
[13] Basaran OE, Guvendag Guven ES, Guven S. First trimester fetal thymus volume may predict preeclampsia. Pregnancy Hypertens 2021; 26: 116– 120.
[14] El-Haieg DO, Zidan AA, El-Nemr MM. The relationship between sonographic fetal thymus size and the components of the systemic fetal inflammatory response syndrome in women with preterm prelabour rupture of membranes. BJOG 2008; 115: 836–841.
[15] Musilova I, Hornychova H, Kostal M, Jacobsson B, Kacerovsky M. Ultrasound measurement of the transverse diameter of the fetal thymus in pregnancies complicated by the preterm prelabor rupture of membranes. J Clin Ultrasound 2013; 41: 283–289.
[16] Yinon Y, Zalel Y, Weisz B, Mazaki-Tovi S, Sivan E, Schiff E, et al. Fetal thymus size as a predictor of chorioamnionitis in women with preterm premature rupture of membranes. Ultrasound Obstet Gynecol 2007; 29: 639–643.
[17] Chaoui R, Heling KS, Lopez AS, Thiel G, Karl K. The thymic-thoracic ratio in fetal heart defects: A simple way to identify fetuses at high risk for microdeletion 22q11. Ultrasound Obstet Gynecol 2011; 37: 397–403.
[18] Gruver AL, Sempowski GD. Cytokines, leptin, and stress-induced thymic atrophy. J Leukocyte Biol 2008; 84: 915–923.
[19] Taub DD, Longo DL. Insights into thymic aging and regeneration. Immunol Rev 2005; 205: 72–93.
[20] Gruver AL, Sempowski GD. Cytokines, leptin, and stress-induced thymic atrophy. J Leukoc Biol 2008; 84: 915–923.
[21] Concordet JP, Ferry A. Physiological programmed cell death in thymocytes is induced by physical stress (exercise). Am J Physiol 1993; 265: C626–C629.
[22] De Felice C, Toti P, Santopietro R, Stumpo M, Pecciarini L, Bagnoli F. Small thymus in very low birth weight infants born to mothers with subclinical chorioamnionitis. J Pediatr 1999; 135: 384–386.
[23] McDade TW, Beck MA, Kuzawa CW, Adair LS. Prenatal undernutrition and postnatal growth are associated with adolescent thymic function. J Nutr 2001; 131: 1225– 1231.
[24] Ferguson AC. Prolonged impairment of cellular immunity in children with intrauterine growth retardation. J Pediatr 1978; 93: 52–56.
[25] Godfrey K, Barker D, Osmond C. Disproportionate fetal growth and raised IgE concentration in adult life. Clin Exp Allergy 1994; 24: 641–648.
[26] Borgelt JMA, Mollers M, Falkenberg MK, Amler S, Klockenbusch W, Schmitz R. Assessment of firsttrimester thymus size and correlation with maternal diseases and fetal outcome. Acta Obstet Gynecol Scand 2016; 95: 210–216.
[27] Dornemann R, Koch R, Möllmann U, Falkenberg MK, Möllers M, Klockenbusch W, et al. Fetal thymus size in pregnant women with diabetic diseases. J Perinat Med 2017; 45: 595–601.
[28] Li L, Bahtiyar MO, Buhimschi CS, Zou L, Zhou QC, Copel JA. Assessment of the fetal thymus by two- and three-dimensional ultrasound during normal human gestation and in fetuses with congenital heart defects. Ultrasound Obstet Gynecol 2011; 37: 404–409.
[29] Warby AC, Amler S, Jacobi AM, Hammer K, Mollmann U, Falkenberg MK, et al. Imaging of fetal thymus in pregnant women with rheumatic diseases. J Perinat Med 2014; 42: 635–639.
[30] Zalel Y, Gamzu R, Mashiach S, Achiron R. The development of the fetal thymus: An in utero sonographic evaluation. Prenat Diagn 2002; 22: 114–117.