Clinical characteristics of pregnant women with an allogeneic fetus
DOI:
https://doi.org/10.15574/HW.2023.164.51Keywords:
assisted reproductive technologies, allogenous fetus, oocyte donation, surrogacy, gynecological history, reproductive history, somatic history, social and demographic factorsAbstract
The development of assisted reproductive technologies (ART) today allows many women to overcome biological barriers to motherhood. However, the use of such relatively new areas as oocyte donation and surrogacy, which result in the formation of an allogeneic fetus, is associated not only with legal but also with medical problems.
Purpose - to analyze the clinical characteristics of pregnant women with an allogeneic fetus and pregnant women who were involved in ART programs with their own oocytes.
Materials and methods. 120 pregnant women were examined, who were divided into the following groups: the Group I - 40 pregnant women who were involved in ART programs using foreign oocytes with the formation of an allogeneic fetus and whose management is planned to be carried out according to an improved algorithm; the Group II - 40 pregnant women who were involved in ART programs using foreign oocytes with the formation of an allogeneic fetus and whose management is planned to be carried out according to the generally accepted algorithm; the Group III - 40 pregnant women who underwent ART using the woman's own oocytes. The features of reproductive and somatic history, as well as social and demographic factors of the patient’s lives, were established.
Results. Among pregnant women with an allogeneic fetus, a significantly higher proportion of women with pelvic inflammatory disease, bacterial vaginosis, cervical pathology, as well as patients with a history of surgical termination of pregnancy at the woman’s request were recorded. At the same time, the rates of registration of late menarche, endometriosis, polycystic ovary syndrome, early spontaneous abortions, as well as the following extragenital pathology: chronic arterial hypertension, diseases of the urinary system, and diabetes mellitus were significantly lower in patients of the Groups I and of the Groups II. The following social and demographic features of patients with an allogeneic fetus were noted: a smaller proportion of women with higher education, as well as those who live in their own home and are in a registered marriage compared to the control group.
Conclusions. Registration of higher levels of a number of gynecological complications in pregnant women with an allogeneic fetus, as well as unfavorable social and demographic factors, requires the development of an improved management algorithm for such women, taking into account these features, which can help to reduce the rates of various obstetric and perinatal complications.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the author.
References
ASRM. (2021). Practice Committee of the American Society for Reproductive Medicine and the Practice Committee for the Society for Assisted Reproductive Technology. Guidance regarding gamete and embryo donation. Fertility and sterility. 115 (6): 1395-1410. https://doi.org/10.1016/j.fertnstert.2021.01.045; PMid:33838871
Beaujouan É. (2021). Late fertility intentions increase over time in Austria, but chances to have a child at later ages remain low. Reprod Biomed Soc Online. 14: 125-139. https://doi.org/10.1016/j.rbms.2021.10.002; PMid:35079645 PMCid:PMC8782643
Chaemsaithong P, Sahota DS, Poon LC. (2022). First trimester preeclampsia screening and prediction. Am J Obstet Gynecol. 226 (2S): S1071-S1097.e2. https://doi.org/10.1016/j.ajog.2020.07.020; PMid:32682859
Chang KJ, Seow KM, Chen KH. (2023). Preeclampsia: Recent Advances in Predicting, Preventing, and Managing the Maternal and Fetal Life-Threatening Condition. Int J Environ Res Public Health. 20 (4): 2994. https://doi.org/10.3390/ijerph20042994; PMid:36833689 PMCid:PMC9962022
Dar S, Lazer T, Swanson S et al. (2015). Assisted reproduction involving gestational surrogacy: an analysis of the medical, psychosocial and legal issues: experience from a large surrogacy program. Human reproduction (Oxford, England). 30 (2): 345-352. https://doi.org/10.1093/humrep/deu333; PMid:25518975
De Geyter C. (2019). Assisted reproductive technology: Impact on society and need for surveillance. Best Pract Res Clin Endocrinol Metab. 33 (1): 3-8. https://doi.org/10.1016/j.beem.2019.01.004; PMid:30799230
Dolmans MM, Lambertini M, Macklon KT, Santos TA, Ruiz-Casado A, Borini A et al. (2019). EUropean REcommendations for female FERtility preservation (EU-REFER): A joint collaboration between oncologists and fertility specialists. Crit Rev Oncol Hematol. 138: 233-240. https://doi.org/10.1016/j.critrevonc.2019.03.010; PMid:31092380
Garcia JE, Rosenwaks Z. (2018). Development of in vitro fertilization in the United States: a conversation between Zev Rosenwaks and Jairo E. Garcia. Fertil Steril. 110 (1): 14-18. dohttps://doi.org/10.1016/j.fertnstert.2018.04.011; PMid:29980255
Johnson MH. (2019). A short history of in vitro fertilization (IVF). Int J Dev Biol. 63 (3-5): 83-92. https://doi.org/10.1387/ijdb.180364mj; PMid:31058305
Kahramanoglu Ö, Schiattarella A, Demirci O, Sisti G, Ammaturo FP, Trotta C et al. (2022). Preeclampsia: state of art and future perspectives. A special focus on possible preventions. J Obstet Gynaecol. 42 (5): 766-777. https://doi.org/10.1080/01443615.2022.2048810; PMid:35469530
Kuchynska OP, Kashyntseva OY, Shchyhol OV. (2020). Current issues of legal regulation of surrogate maternity and enforcement of rights of surrogate mothers. Wiad Lek. 73 (12 cz 2): 2871-2876. https://doi.org/10.36740/WLek202012228; PMid:33611296
Luke B. (2017). Pregnancy and birth outcomes in couples with infertility with and without assisted reproductive technology: with an emphasis on US population-based studies. American journal of obstetrics and gynecology. 217 (3): 270-281. https://doi.org/10.1016/j.ajog.2017.03.012; PMid:28322775 PMCid:PMC9761478
Mintser AP. (2018). Statisticheskie metodyi issledovaniya v klinicheskoy meditsine. Prakticheskaya meditsina. 3: 41-45.
Monari F, Bascio LS, Banchelli F, Neri I, Bertucci E, Ferrari F et al. (2022). First-trimester prediction model for placental vascular disorders: An observational prospective study. Pregnancy Hypertens. 28: 35-40. https://doi.org/10.1016/j.preghy.2022.02.002; PMid:35168013
Niederberger C, Pellicer A, Cohen J et al. (2018). Forty years of IVF. Fertil Steril. 110 (2): 185-324. e5. https://doi.org/10.1016/j.fertnstert.2018.06.005; PMid:30053940
Piersanti V, Consalvo F, Signore F, Del Rio A, Zaami S. (2021). Surrogacy and «Procreative Tourism». What Does the Future Hold from the Ethical and Legal Perspectives? Medicina (Kaunas). 57 (1): 47. https://doi.org/10.3390/medicina57010047; PMid:33429930 PMCid:PMC7827900
Pizitz TD, McCullaugh J, Rabin A. (2013). Do women who choose to become surrogate mothers have different psychological profiles compared to a normative female sample? Women Birth. 26 (1): e15-20. https://doi.org/10.1016/j.wombi.2012.06.003; PMid:22819949
Reznik OM, Yakushchenko YM. (2020). Legal considerations surrounding surrogacy in Ukraine. Wiad Lek. 73 (5): 1048-1052. https://doi.org/10.36740/WLek202005139; PMid:32386393
Riddle MP. (2020). Psychological assessment of gestational carrier candidates: current approaches, challenges, and future considerations. Fertil Steril. 113 (5): 897-902. https://doi.org/10.1016/j.fertnstert.2020.02.104; PMid:32312559
Shanyun X. (2022). Uterus rental: Regulating surrogacy in China. Med Leg J. 90 (1): 41-44. https://doi.org/10.1177/00258172211060192; PMid:35156432
Skakkebæk NE, Lindahl-Jacobsen R, Levine H, Andersson AM, Jørgensen N, Main KM et al. (2022). Environmental factors in declining human fertility. Nat Rev Endocrinol. 18 (3): 139-157. https://doi.org/10.1038/s41574-021-00598-8; PMid:34912078
Somigliana E, Mangili G, Martinelli F, Noli S, Filippi F, Bergamini A et al. (2020). Fertility preservation in women with cervical cancer. Crit Rev Oncol Hematol. 154: 103092. https://doi.org/10.1016/j.critrevonc.2020.103092; PMid:32896752
Steptoe PC, Edwards RG. (1978). Birth after the reimplantation of a human embryo. Lancet. 2 (8085): 366. https://doi.org/10.1016/S0140-6736(78)92957-4; PMid:79723
Sullivan-Pyke CS, Senapati S, Mainigi MA, Barnhart KT. (2017). In Vitro fertilization and adverse obstetric and perinatal outcomes. Semin Perinatol. 41 (6): 345-353. https://doi.org/10.1053/j.semperi.2017.07.001; PMid:28818301 PMCid:PMC5951714
Te Velde E, Habbema D, Leridon H, Eijkemans M. (2012). The effect of postponement of first motherhood on permanent involuntary childlessness and total fertility rate in six European countries since the 1970s Hum Reprod. 27 (4): 1179-1183. https://doi.org/10.1093/humrep/der455; PMid:22258662
Torres G, Shapiro A, Mackey TK. (2019). A review of surrogate motherhood regulation in south American countries: pointing to a need for an international legal framework. BMC Pregnancy Childbirth. 19 (1): 46. https://doi.org/10.1186/s12884-019-2182-1; PMid:30691390 PMCid:PMC6350392
Woo I, Hindoyan R, Landay M et al. (2017). Perinatal outcomes after natural conception versus in vitro fertilization (IVF) in gestational surrogates: a model to evaluate IVF treatment versus maternal effects. Fertility and sterility. 108 (6): 993-998. https://doi.org/10.1016/j.fertnstert.2017.09.014; PMid:29202976
Wyns C, De Geyter C, Calhaz-Jorge C, Kupka MS, Motrenko T, Smeenk J et al. (2022). European IVF Monitoring Consortium (EIM), for the European Society of Human Reproduction and Embryology (ESHRE), ART in Europe, 2018: results generated from European registries by ESHRE. Human reproduction open. 3: hoac022. https://doi.org/10.1093/hropen/hoac022; PMid:35795850 PMCid:PMC9252765
Ye M, Yeh J, Kosteria I, Li L. (2020). Progress in Fertility Preservation Strategies in Turner Syndrome. Front Med (Lausanne). 7: 3. Published 2020 Jan 24. https://doi.org/10.3389/fmed.2020.00003; PMid:32039223 PMCid:PMC6993200
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Ukrainian Journal Health of Woman
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal UKRAINIAN JOURNAL «HEALTH OF WOMAN» is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license (СС BY-NC).
Authors transfer the copyright to the Journal UKRAINIAN JOURNAL «HEALTH OF WOMAN» when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
