Publication: Maternal plasma has higher hormone levels in pregnancies conceived with infertility

Differences in First Trimester Maternal Metabolomic Profiles in Pregnancies Conceived from Fertility Treatments.

Sun T, Lee B, Kinchen J, Wang ET, Gonzalez TL, Chan JL, Rotter JI, Chen YI, Taylor K, Goodarzi MO, Rich SS, Farber CR, Williams J 3rd, Pisarska MD.

J Clin Endocrinol Metab. 2018 Nov 15. doi: 10.1210/jc.2018-01118.

Links

• PubMed ID: 30445606
• The Journal of Clinical Endocrinology & Metabolism

Highlights

• We looked at metabolites circulating in maternal blood (specifically plasma) around late first trimester of pregnancy.
• Hormone levels (beta-estradiol and progesterone) were higher in patients with infertility, compared to patients who did not receive fertility treatments.
• ELISA assays with maternal plasma confirmed these results.

Abstract

CONTEXT: Maternal metabolic status reflects underlying physiological changes in the maternal-placental-fetal unit, which can identify contributors to adverse pregnancy outcomes associated with infertility and treatments utilized.

OBJECTIVE: To determine if maternal metabolomic profiles are different between spontaneous pregnancies and pregnancies conceived with fertility treatments, including in vitro fertilization (IVF) and non-IVF fertility treatments (NIFT) that may explain differences in pregnancy outcomes.

DESIGN: Metabolon® metabolomic analysis and ELISA assays for 17-β-estradiol and progesterone were performed during the late first trimester from spontaneous conceptions and those conceived through fertility treatments, including NIFT and IVF.

SETTING: Academic institution.

SUBJECTS: The SMAART (Spontaneous/Medically Assisted/ART) cohort which consisted of 409 women, 208 conceived spontaneously, 201 with infertility that used fertility treatments (90 NIFT, 111 IVF).

INTERVENTION(S): Mode of conception (Spontaneous, NIFT and IVF).

MAIN OUTCOME MEASURE(S): 806 metabolites within 8 super pathways, 17-β-estradiol and progesterone levels in maternal plasma in the late first trimester.

RESULTS: Metabolomic differences in the lipid super pathway (steroid metabolites, lipids with DHA acyl chains, acyl cholines), xanthine and benzoate metabolites (p<0.05) were significantly different among the Spontaneous and Infertility groups, with greatest differences between Spontaneous and IVF groups. 17-β-estradiol and progesterone were significantly elevated in the Infertility group, with greatest differences among the Spontaneous and IVF groups.

CONCLUSIONS: Metabolomic profiles differ between spontaneous and infertility pregnancies, likely driven by IVF. Elevated steroids and their metabolites are likely due to increased hormone production from placenta reprogrammed from fertility treatments which may contribute to adverse outcomes associated with infertility and treatments utilized.