Systemic vascular resistance may influence the outcome of in vitro fertilization

Abstract

Introduction: The number of pregnancies obtained through in vitro fertilization (IVF) techniques are increasing, and only few studies have investigated hemodynamic variations in women undergoing IVF techniques. The aim of this study was to evaluate the hemodynamic parameters in women undergoing IVF, to assess a possible correlation between hemodynamics and embryo implantation.

Methods: 45 normotensive non-obese women, age ≤ 43 years, with idiopathic or tubal infertility, referred to the Reproductive Physiopathology and Andrology Unit, Sandro Pertini Hospital, Rome, during the period 2020/2021, underwent IVF techniques. All women were evaluated with Ultra Sonic Cardiac Output Monitor (USCOM) to detect hemodynamic parameters at two different stages: at the mid-luteal phase, before the beginning of IVF, and at the day of embryo transfer (dET). All demographics and hormonal parameters in both groups were comparable. The hemodynamic parameters were compared between women with a positive β-HCG test vs. those testing negative.

Results: 11 out of 45 (24,5%) women obtained positive β-HCG test. All demographics and hormonal parameters were comparable in both groups. Women with a positive β-HCG test showed statistically lower systemic vascular resistance (SVR) at mid-luteal phase (868.61 ± 100.1 vs. 1009 ± 168.4) and dET (818,9 ± 104.5 vs 1038.52 ± 150.82 dynes × s/cm⁵).

Conclusions: Hemodynamic assessment can identify a more favorable pre-pregnancy cardiovascular adaptation. Embryo implantation might be positively influenced by the hemodynamic parameters, e.g. lower SVR, before the beginning of IVF techniques, and during the window of implantation.

摘要

介绍:通过体外受精(IVF)技术获得的妊娠数量正在增加, 但只有少数研究对接受体外受精技术的女性进行血流动力学调查。本研究的目的是评估体外受精女性的血液动力学参数, 以评价血液动力学和胚胎植入之间可能的相关性。

方法:选择2020/2021年在罗马桑德罗·佩尔蒂尼医院生殖生理病理学和男科就诊的45名血压正常的非肥胖女性, 年龄≤43岁, 患有特发性或输卵管性不孕症, 进行体外受精治疗。所有女性在黄体中期、体外受精前和胚胎移植(DET)当天分别用超声心输出量监测仪(USCOM)检测血流动力学参数。两组的所有人口统计学数据和激素参数均具有可比性。研究对β-HCG阳性和阴性女性的血流动力学参数进行了比较。

结果:45例女性中有11例(24.5%)β-HCG检测阳性。两组的所有人口统计学数据和激素参数均具有可比性。β-HCG阳性的女性在黄体中期(868.61 ± 100.1 vs. 1009 ± 168.4)和胚胎移植当天(818,9 ± 104.5 vs 1038.52 ± 150.82 dynes × s/cm⁵)显示较低的全身血管阻力(SVR)。

结论:血流动力学评估可以确定更有利的孕前心血管适应。血流动力学参数的改变可能对胚胎植入有积极影响, 如在体外受精技术开始前和植入窗口期降低SVR。

Keywords:

• In vitro fertilization techniques
• hemodynamic assessment
• embryo implantation
• Systemic vascular resistance

关键词:

• 体外受精技术
• 血流动力学评估
• 胚胎植入全身血管阻力

Acknowledgements

All medical doctors and biologist of Reproductive Physiopathology and Andrology Unit, ‘Sandro Pertini Hospital’, Rome.

Disclosure statement

The authors declare that they have no conflicts of interest and nothing to disclose.

Additional information

Funding

This research received no external funding.