menotropins and Down-Syndrome

Maternal serum alpha-fetoprotein (AFP), human chorionic gonadotrophin (hCG), and unconjugated oestriol (uE3) levels were examined in 1632 women who had ovulation induction and 327 who had in vitro fertilization. There was a highly statistically significant increase in hCG and reduction in uE3 among those with ovulation induction. The median levels were respectively 1.09 and 0.92 multiples of the normal gestation-specific median (MOM) based on a total of 34582 women. Ovulation induction appeared to have no material effect on the median AFP level but this masked a significant increase when treatment was with Clomiphene (1.05 MOM) and a significant decrease when Pergonal was used (0.93 MOM). There was a highly statistically significant reduction in uE3 among women having in vitro fertilization with a median level of 0.92 MOM. Those fertilized with a donor egg (21) had significantly higher AFP and uE3 levels than when their own egg was used. Our results were confounded by differences in gravidity, but formally allowing for this factor did not materially change the findings. None of the observed effects is great enough to warrant routine adjustment of marker levels to allow for them. Moreover, women with positive Down's syndrome screening results can be reassured that this is unlikely to be due to them having had assisted reproduction.

Topics: alpha-Fetoproteins; Biomarkers; Chorionic Gonadotropin; Clomiphene; Down Syndrome; Estriol; Female; Fertilization in Vitro; Gestational Age; Humans; Menotropins; Ovulation Induction; Pregnancy; Prenatal Diagnosis; Reproductive Techniques

The case history of a 35-year-old woman with a pregnancy following IVF treatment is presented. Transvaginal sonography revealed an abnormal pattern of the embryonic heart rate between 28 and 50 days following follicular aspiration. At term, a male infant with the characteristics of Down's syndrome was born. The diagnosis was confirmed by chromosome analysis. The implications of this observation are discussed.

Topics: Adult; Chorionic Gonadotropin; Down Syndrome; Embryo Transfer; Female; Fertilization in Vitro; Fetal Diseases; Follicle Stimulating Hormone; Gestational Age; Heart Rate, Fetal; Humans; Infertility, Female; Karyotyping; Male; Menotropins; Pregnancy; Ultrasonography

The first case of a genetic abnormality in a 3-year in vitro fertilization and embryo transfer program was diagnosed after routine amniocentesis of a 38-year-old patient. The G-banded karyotype analysis gave 47, XY, +21, which constitutes an abnormal chromosome pattern consistent with Down syndrome.

Topics: Adult; Down Syndrome; Embryo Transfer; Fertilization in Vitro; Humans; Karyotyping; Menotropins

Topics: Abnormalities, Drug-Induced; Abnormalities, Multiple; Adult; Amenorrhea; Down Syndrome; Drug Evaluation; Female; Follow-Up Studies; Humans; Infant, Newborn; Infertility, Female; Menotropins; Ovulation; Pregnancy; Triplets; Twins

Topics: Amenorrhea; Amniocentesis; Amniotic Fluid; Chorionic Gonadotropin; Chromosome Aberrations; Chromosomes, Human, 13-15; Chromosomes, Human, 21-22 and Y; Down Syndrome; Female; Genetic Counseling; Humans; Infant, Newborn; Karyotyping; Menotropins; Ovulation; Pregnancy