4.3 Review

Increased Risk of Preeclampsia with Assisted Reproductive Technologies

Journal

CURRENT HYPERTENSION REPORTS
Volume 25, Issue 9, Pages 251-261

Publisher

SPRINGER
DOI: 10.1007/s11906-023-01250-8

Keywords

Preeclampsia; Hypertensive disorders of pregnancy; Pregnancy complications; Assisted reproductive technology; Frozen embryo transfer

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This review assesses the association between assisted reproductive technology (ART) and preeclampsia, based on recent available data. Retrospective clinical studies predominantly support the link between ART and preeclampsia. Both clinical and pre-clinical studies suggest that specific ART procedures, such as in vitro embryo handling and development, hormone stimulation, transfer cycle types, and use of donor oocytes/embryos, may contribute to the increased risk. Potential mechanisms include epigenetic aberrations, absence of factors secreted by the corpus luteum, and immunologic responses to allogenic gametes.
Purpose of ReviewWe summarized recent available data to assess the association between assisted reproductive technology (ART) and risk for preeclampsia.Recent FindingsThe majority of clinical studies supporting the association of preeclampsia and ART are retrospective. Published data from both clinical and pre-clinical studies suggest specific ART procedures may contribute to the increased risk, including in vitro embryo handling and development, hormone stimulation, transfer cycle types, and use of donor oocytes/embryos. Potential mechanisms include epigenetic aberrations leading to abnormal placentation, absence of factors secreted by the corpus luteum, and immunologic responses to allogenic gametes.There is an increased risk of preeclampsia following ART. Treatment plans that favor reduced preeclampsia risk should be considered for ART pregnancies. To make ART pregnancies safer, additional clinical and animal model studies are needed to elucidate the underpinnings of this risk association.

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