Objective:
In-vitro fertilization (IVF) is associated with an increased risk of preeclampsia, but the reasons are poorly understood. We hypothesized that a non-physiologic number of corpora lutea (CL) increases the risk of preeclampsia.
Methods:
892 infertile women were enrolled in this prospective cohort study. Four categories based on CL status were defined: (1) absence of the CL; (2) single CL; (3) multiple CL associated with ovulation induction; (4) multiple CL associated with controlled ovarian stimulation for IVF with fresh embryo transfer. Analysis focused on singleton pregnancies conceived with autologous oocytes resulting in live birth (n = 683). Multivariable logistic regression controlled for covariates.
Results:
Compared with conceptions occurring in the presence of one CL, conceptions occurring in the absence of a CL were associated with a higher incidence of preeclampsia (12.8% vs. 4.8%, P= 0.02) and preeclampsia with severe features (9.6% vs. 1.4%, P< 0.001). Compared with FET occurring in the presence of one CL (modified natural cycles), FET occurring in the absence of a CL (programmed cycles) were associated with a higher incidence of preeclampsia (12.8% vs. 3.9%, P= 0.02) and preeclampsia with severe features (9.6% vs. 0.8%, P= 0.002). In multivariable regression models, absence of the CL was predictive for preeclampsia (AOR 2.73; 1.14 – 6.49) and preeclampsia with severe features (AOR 6.45; 1.94 – 25.09) compared to the presence of one CL.
Summary:
Singleton live births conceived in the absence of a CL were at increased risk for development of preeclampsia and preeclampsia with severe features.
