Prenatal diagnostics in TESA/PESA pregnancies in Denmark 1995-2007: a shift from invasive procedures to nuchal translucency examination

Abstract

Evidently, children born after intracytoplasmic sperm injection (ICSI) are at an increased risk of having sex chromosomal abnormalities. Here we evaluate the change in methods used for prenatal diagnostics in patients having ICSI with epididymal or testicular sperm from the introduction of the procedure in 1995 until December 2007. Four hundred and fifty pregnancies resulted in the birth of 553 children. Of the Danish subpopulation 115 (34.2%) received nuchal translucency examination (NT) and 43 (12.8%) received invasive prenatal diagnostics (IPD). IPD was carried out in 11 out of 23 couples (48%) during the period 1995–1998. Since 2002, less than 10% chose to receive IPD. Twenty-one (57%) of 37 Danish women 37–44 years of age underwent IPD compared to only 22 (7.4%) of the 299 women less than 37 years of age (p < 0.001). Conversely, since 1999 the use of NT has gradually increased to a frequency of 88.9% in 2007. The partners of vasectomized men had significantly more often NT performed compared to those of non-vasectomized men. IPD were not otherwise associated with the etiology of azoospermia. This study documents a shift in prenatal diagnostics from IPD to NT for testicular sperm aspiration/percutaneous epididymal sperm aspiration (TESA/PESA) couples.

Keywords:

• amniocentesis
• assisted reproduction
• chorionic villus biopsy
• nuchal translucency examination
• prenatal diagnostics

Acknowledgments

The authors wish to thank the following colleagues all of whom contributed important data.

Colleagues from the following fertility clinics in Denmark:

Skejby Hospital (Erik Ernst), Herlev Hospital (Hjördis Mikkelsen, Trine Lemvigh and Hanne Udengaard), Ballerup Fertilitetsklinik (Peter Lundström), Nordica Fertility Clinic (Mette Munk), Horsens Fertilitetsklinik (Gerhardt Børlum), Holbæk Fertilitetsklinik (Torben Philipsen) and Trianglen (Jorgen Grinsted)

Colleagues from the following obstetrical departments:

DENMARK:

Gentofte Hospital (Annamari Nikkilä), Roskilde Hospital (Lennart Isager-Sally), Sygehus Lillebælt (Kolding, Fredericia), Rigshospitalet, Copenhagen (Anne Loft), Aalborg Sygehus (Bjørn Pedersen), Hjørring Sygehus (Bjørn Petersen), Hvidovre Hospital (Finn Stener Jørgensen), Herlev Hospital (Hanne Udengaard), Glostrup Hospital (Helle Zingenberg), Nordsjællands Hospital, Hillerød (Tina Sejersbøl Wagner), Regionshospitalet Randers (Karin Roed Meyer), Næstved Sygehus (Susanne Pouplier), Sydvestjysk Sygehus, Esbjerg and Grindsted (Hans Ole Daugaard), Regionshospitalet Horsens (Marianne Christiansen), Svendborg Sygehus (Merete Skov), Sygehus Thy-Mors, Thisted (Richard Farlie), Skejby Sygehus (Niels Uldbjerg), Regionshospitalet Viborg (Lars Schierup), Sygehus Sønderjylland, Sønderborg (Pia Pallesen), Storstrømmens Sygehus, Nykøbing Falster (Jens Christian Prien-Larsen), Bornholms Hospital (Hans Grundsell), Sygehus Sønderjylland, Haderslev (Hanne Christensen), Slagelse Sygehus (Jens Ole Fall), Regionshospitalet Silkeborg (Mette Heinel Frederiksen), Hospitalsenheden Vest, Herning, Holstebro (Carsten Byrjalsen)

NORWAY:

Rikshospitalet, Oslo (Peter Fedorcsak), Haukeland Sykehus, Bergen (Synnøve Lian Johnsen), Stavanger Sentralsykehus, St.Olavs Hospital, Trondheim, Lillehammer Sykehus, Kristiansand Sykehus, Dr. Ernst Faber Swenson, Kristansand, Dr. Johan Bergh, Hafrsfjord, Sentralsykehuset i Rogaland, Stavanger (Torbjørn Moe Eggebø), Frederikstad Sentralsykehus, Akershus Universitetssykehus, Oslo (Seth Granberg), Dr. Merethe Blakstad, Oslo, Vest Agder Sentralsykehus, Aust Agder Sentralsykehus, Nordfjord Sykehus, Elverum Sentralsykehus, Sykehuset Innlandet, Gjøvik (Anja Døssland Holstad), Sykehuset Asker og Bærum (Kjartan Moe), Vestfold Sentralsykehus (Dr. Knut Urdal), Aker Sykehus, Oslo, Orkdal Sjukehus, Orhanger, Ullevål Universitetssykehus (Bjørn Busund), Sykehuset Telemark (Eirik Eliassen), Kongsberg Sykehus, Harstad Sykehus, Sentralsykehuset Østfold, Frederikstad, Sentralsykehuset Møre/Romsedal/Ålesund, Haugesund Sykehus (Torolf Holst-Larsen), Fylkesjukehuset i Kristiansund (Ellen Jendal), Lister Sykehus, Flekkefjord, Sentralsjukehuset Buskerud (Marieke Claessen), Stora Fylkesjukehus

THE FAROE ISLANDS:

Torshavn Sygehus

SWEDEN:

Blekingesjukhuset, Karlshamn (Per Buchhave)

Declaration of Interest: The authors have no financial or personal conflicts of interest. Collection of supplementary information from the obstetrical departments and all data work was performed by JF. The authors are responsible for the content and JF, AL, and MDK for the writing of the paper.