Preeclampsia Risk and Frozen Embryo Transfer; Is it All About Preparation?

Authors

Erin L. Gysbers, University of LynchburgFollow

Specialty

Women's Health

Advisor

Dr. Laura Witte, Ph.D., PA-C

Abstract

ABSTRACT

Purpose: The purpose of this review is to determine the prevalence of preeclampsia following frozen embryo transfer comparing various endometrial preparation methods.

Method: An article search was conducted using Pubmed, MEDLINE, and Google Scholar search engines. Search terms included preeclampsia AND corpus luteum. The initial search yielded 743 articles. The search was narrowed down by selecting the following article types: clinical trial, meta-analysis, randomized controlled trial, review, and systematic review. Additional filters included publication date within five years (2016-2021), human species, and English language. Articles that involved research of specific causes of infertility (such as polycystic ovarian syndrome), freeze/thawing techniques of frozen embryos, donor embryo transfer, hypertensive disorders of pregnancy (not specific to only preeclampsia), embryo stage at transfer, measurement of hormone levels, specific medications used for endometrial preparation, or neonatal complications were excluded. A review of titles, abstracts, and reference sections yielded thirteen articles that met the inclusion criteria for this literature review.

Results: Several studies and scholarly reviews have demonstrated an increased prevalence of preeclampsia following frozen embryo transfer (FET) versus fresh embryo transfer (fresh ET). Explanations suggested for this finding include endometrial preparation methods and the absence of a corpus luteum of pregnancy. This clinical literature review indicates that programmed (artificial) FET is associated with a higher risk of preeclampsia than natural and stimulated FET cycles.

Conclusion: With the incidence of infertility and use of assisted reproductive technology (ART) increasing, it is essential to determine how to minimize maternal complications following ART interventions. The popularity of FET cycles and freeze-all cycles utilized in the treatment of infertility is growing at a rapid rate. Endometrial preparation and the number (or lack thereof) of corpus luteum may change the risk of the maternal complication preeclampsia. Though more research is needed in this area, this review suggests that, in order to minimize the risk of preeclampsia, it may be important to alter endometrial preparation for FET cycles based upon a patient’s preexisting risk factors.

Keywords: preeclampsia, assisted reproductive technology, in-vitro fertilization, frozen embryo transfer, fresh embryo transfer, corpus luteum, and endometrial preparation

Recommended Citation

Gysbers EL. Preeclampsia Risk and Frozen Embryo Transfer; Is it All About Preparation?. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2021; 4(1).