Skip to main content
Erschienen in: Journal of Assisted Reproduction and Genetics 4/2019

05.01.2019 | Assisted Reproduction Technologies

Hydatidiform molar pregnancy following assisted reproduction

verfasst von: M. Nickkho-Amiry, G. Horne, M. Akhtar, R. Mathur, D. R. Brison

Erschienen in: Journal of Assisted Reproduction and Genetics | Ausgabe 4/2019

Einloggen, um Zugang zu erhalten

Abstract

Introduction

The use of assisted reproduction techniques (ART) is increasing; however, reports of molar pregnancy following ART remain scarce. Currently, the Human Fertility and Embryology Authority (HFEA) collates data on the molar pregnancies that have resulted through the use of ART. Recently, they have indicated that they will no longer collect these data.

Aim

This paper aimed to examine the incidence of molar pregnancy amongst patients undergoing assisted reproduction.

Methods

We contacted HFEA and placed a request under the Freedom of Information Act (2000) for the number of molar pregnancies that resulted from fresh/frozen embryo transfer since HFEA started collecting data in 1991 to February 2018. We also asked how many patients who had suffered a molar pregnancy went on to have a normal pregnancy and how many had subsequent molar pregnancies, in subsequent treatment cycles.

Results

Between 68 and 76 molar pregnancies occurred within this period using ART (n = 274,655). The incidence of molar pregnancy using fresh intracytoplasmic sperm injection (ICSI) (1/4302) and fresh in vitro fertilisation (IVF) (1/4333) was similar. The risk of recurrence of molar pregnancy following a previous molar was higher following ART compared to spontaneous conceptions.

Conclusion

The use of ICSI should be protective against triploidy; however, the retrospective data suggests that molar pregnancy is not eliminated with the use of ART. It is pertinent to continue to record this data, through the gestational trophoblastic disease centres, in order to ensure no further increase in incidence, appropriate follow-up, and transparency in communication.
Literatur
1.
Zurück zum Zitat The management of gestational trophoblastic disease. Green top guideline number 38. Royal College of Obstetricians. 2010. The management of gestational trophoblastic disease. Green top guideline number 38. Royal College of Obstetricians. 2010.
2.
Zurück zum Zitat Berkowitz RS, Bernstein MR, Laborde O, Goldstein DP. Subsequent pregnancy experience in patients with gestational trophoblastic disease. New England Trophoblastic Disease Center, 1965–1992. J Reprod Med. 1994;39:228–32.PubMed Berkowitz RS, Bernstein MR, Laborde O, Goldstein DP. Subsequent pregnancy experience in patients with gestational trophoblastic disease. New England Trophoblastic Disease Center, 1965–1992. J Reprod Med. 1994;39:228–32.PubMed
3.
Zurück zum Zitat Berkowitz RS, Im SS, Bernstein MR, Goldstein DP. Gestational trophoblastic disease. Subsequent pregnancy outcome, including repeat molar pregnancy. J Reprod Med. 1998;43:81–6.PubMed Berkowitz RS, Im SS, Bernstein MR, Goldstein DP. Gestational trophoblastic disease. Subsequent pregnancy outcome, including repeat molar pregnancy. J Reprod Med. 1998;43:81–6.PubMed
4.
Zurück zum Zitat Berkowitz RS, Goldstein DP. Clinical practice. Molar pregnancy. N Engl J Med. 2009;360:1639–45.CrossRefPubMed Berkowitz RS, Goldstein DP. Clinical practice. Molar pregnancy. N Engl J Med. 2009;360:1639–45.CrossRefPubMed
5.
Zurück zum Zitat Slim R, Mehio A. The genetics of hydatidiform moles: new lights on an ancient disease. Clin Genet. 2007;71:25–34.CrossRefPubMed Slim R, Mehio A. The genetics of hydatidiform moles: new lights on an ancient disease. Clin Genet. 2007;71:25–34.CrossRefPubMed
6.
Zurück zum Zitat Fluker MR, Yuzpe AA. Partial hydatidiform mole following transfer of a cryopreserved-thawed blastocyst. Fertil Steril. 2000;74(4):828–9.CrossRefPubMed Fluker MR, Yuzpe AA. Partial hydatidiform mole following transfer of a cryopreserved-thawed blastocyst. Fertil Steril. 2000;74(4):828–9.CrossRefPubMed
7.
Zurück zum Zitat Golubovsky MD. Postzygotic diploidization of triploids as a source of unusual cases of mosaicism, chimerism and twinning. Hum Reprod. 2003;18:236–42.CrossRefPubMed Golubovsky MD. Postzygotic diploidization of triploids as a source of unusual cases of mosaicism, chimerism and twinning. Hum Reprod. 2003;18:236–42.CrossRefPubMed
8.
Zurück zum Zitat Hoffner L, Surti U. The genetics of gestational trophoblastic disease: a rare complication of pregnancy. Cancer Genet. 2012;205:63–77.CrossRefPubMed Hoffner L, Surti U. The genetics of gestational trophoblastic disease: a rare complication of pregnancy. Cancer Genet. 2012;205:63–77.CrossRefPubMed
9.
Zurück zum Zitat Zaragoza MV, Surti U, Redline RW, Millie E, Chakravarti A, Hassold TJ. Parental origin and phenotype of triploidy in spontaneous abortions: predominance of diandry and association with the partial hydatidiform mole. Am J Hum Genet. 2000;66:1807–20.CrossRefPubMedPubMedCentral Zaragoza MV, Surti U, Redline RW, Millie E, Chakravarti A, Hassold TJ. Parental origin and phenotype of triploidy in spontaneous abortions: predominance of diandry and association with the partial hydatidiform mole. Am J Hum Genet. 2000;66:1807–20.CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Bates M, Everard J, Wall L, Horsman JM, Hancock BW. Is there a relationship between treatment for infertility and gestational trophoblastic disease? Hum Reprod. 2004;19:365–7.CrossRefPubMed Bates M, Everard J, Wall L, Horsman JM, Hancock BW. Is there a relationship between treatment for infertility and gestational trophoblastic disease? Hum Reprod. 2004;19:365–7.CrossRefPubMed
11.
12.
Zurück zum Zitat Edwards R, Crow J, Dale S, Macnamee M, Hartshorne G, Brinsden P. Pre-implantation diagnosis and recurrent hydatidiform mole. Lancet. 1990;335:1030–1.CrossRefPubMed Edwards R, Crow J, Dale S, Macnamee M, Hartshorne G, Brinsden P. Pre-implantation diagnosis and recurrent hydatidiform mole. Lancet. 1990;335:1030–1.CrossRefPubMed
13.
Zurück zum Zitat Reubinoff BE, Lewin A, Verner M, Safran A, Schenker JG, Abeliovich D. Intra-cytoplasmic sperm injection combined with pre-implantation genetic diagnosis for the prevention of recurrent gestational trophoblastic disease. Hum Reprod. 1997;12:805–8.CrossRefPubMed Reubinoff BE, Lewin A, Verner M, Safran A, Schenker JG, Abeliovich D. Intra-cytoplasmic sperm injection combined with pre-implantation genetic diagnosis for the prevention of recurrent gestational trophoblastic disease. Hum Reprod. 1997;12:805–8.CrossRefPubMed
14.
Zurück zum Zitat Rosenbusch B, Schneider M, Sterzik K. The chromosomal constitution of multi-pronuclear zygotes resulting from in-vitro fertilization. Hum Reprod. 1997;12:2257–62.CrossRefPubMed Rosenbusch B, Schneider M, Sterzik K. The chromosomal constitution of multi-pronuclear zygotes resulting from in-vitro fertilization. Hum Reprod. 1997;12:2257–62.CrossRefPubMed
15.
16.
Zurück zum Zitat Grossmann M, Calafell JM, Brandy N, Vanrell JA, Rubio C, Pellicer A, et al. Origin of tri-pronucleate zygotes after intracytoplasmic sperm injection. Hum Reprod. 1997;12:2762–5.CrossRefPubMed Grossmann M, Calafell JM, Brandy N, Vanrell JA, Rubio C, Pellicer A, et al. Origin of tri-pronucleate zygotes after intracytoplasmic sperm injection. Hum Reprod. 1997;12:2762–5.CrossRefPubMed
17.
Zurück zum Zitat Macas E, Imthurn B, Keller PJ. Increased incidence of numerical chromosome abnormalities in spermatozoa injected into human oocytes by ICSI. Hum Reprod. 2001;16:115–20.CrossRefPubMed Macas E, Imthurn B, Keller PJ. Increased incidence of numerical chromosome abnormalities in spermatozoa injected into human oocytes by ICSI. Hum Reprod. 2001;16:115–20.CrossRefPubMed
18.
Zurück zum Zitat Rosen M, Shen S, Dobson AT, Fujimoto VY, McCulloch CE, Cedars MI. Triploidy formation after intracytoplasmic sperm injection may be a surrogate marker for implantation. Fertil Steril. 2006;85(2):384–90.CrossRefPubMed Rosen M, Shen S, Dobson AT, Fujimoto VY, McCulloch CE, Cedars MI. Triploidy formation after intracytoplasmic sperm injection may be a surrogate marker for implantation. Fertil Steril. 2006;85(2):384–90.CrossRefPubMed
19.
Zurück zum Zitat Nagy ZP, Staessen C, Liu J, Joris H, Devroey P, Van Steirteghem AC. Prospective, auto-controlled study on reinsemination of failed-fertilized oocytes by intracytoplasmic sperm injection. Fertil Steril. 1995;64:1130–5.CrossRefPubMed Nagy ZP, Staessen C, Liu J, Joris H, Devroey P, Van Steirteghem AC. Prospective, auto-controlled study on reinsemination of failed-fertilized oocytes by intracytoplasmic sperm injection. Fertil Steril. 1995;64:1130–5.CrossRefPubMed
20.
Zurück zum Zitat Chen C, Kattera S. Rescue ICSI of oocytes that failed to extrude the second polar body 6 h post-insemination in conventional IVF. Hum Reprod. 2003;18:2118–21.CrossRefPubMed Chen C, Kattera S. Rescue ICSI of oocytes that failed to extrude the second polar body 6 h post-insemination in conventional IVF. Hum Reprod. 2003;18:2118–21.CrossRefPubMed
21.
Zurück zum Zitat Egozcue S, Blanco J, Vidal F, Egozcue J. Diploid sperm and the origin of triploidy. Hum Reprod. 2002;17:5–7.CrossRefPubMed Egozcue S, Blanco J, Vidal F, Egozcue J. Diploid sperm and the origin of triploidy. Hum Reprod. 2002;17:5–7.CrossRefPubMed
22.
Zurück zum Zitat Rosenbusch BE. Mechanisms giving rise to triploid zygotes during assisted reproduction. Fertil Steril. 2008;90:49–55.CrossRefPubMed Rosenbusch BE. Mechanisms giving rise to triploid zygotes during assisted reproduction. Fertil Steril. 2008;90:49–55.CrossRefPubMed
Metadaten
Titel
Hydatidiform molar pregnancy following assisted reproduction
verfasst von
M. Nickkho-Amiry
G. Horne
M. Akhtar
R. Mathur
D. R. Brison
Publikationsdatum
05.01.2019
Verlag
Springer US
Erschienen in
Journal of Assisted Reproduction and Genetics / Ausgabe 4/2019
Print ISSN: 1058-0468
Elektronische ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-018-1389-9

Weitere Artikel der Ausgabe 4/2019

Journal of Assisted Reproduction and Genetics 4/2019 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.