Aberrant corpus luteum number is associated with altered maternal vascular health in early pregnancy – a contributor to increased preeclampsia risk after assisted reproduction?
20. September 2018 (online)
Assisted reproduction is associated with an increased risk for preeclampsia but the reasons are mainly unstudied. We determined if a non-physiologic hormonal milieu influenced by the number of corpora lutea (CL) and the mode of conception affect maternal vascular health in early pregnancy.
In a prospective cohort of women at 11 to 14 weeks' gestation (N = 57) blood pressure, endothelial function, circulating endothelial progenitor cell (CPC) numbers, lipids, and CL hormones were compared by number of CL and mode of conception: 0 CL (programmed frozen embryo transfer (FET)); 1 CL (spontaneous pregnancy after infertility or modified natural cycle FET); or > 3 CL associated with in-vitro fertilization.
Women with 0 or > 3 CL lacked the drop in mean arterial blood pressure compared to women with one CL (P= 0.05; P= 0.05). Reactive Hyperemia Index (RHI) was impaired in patients lacking a CL compared to 1 CL (P= 0.04). Baseline pulse wave amplitude was higher in subjects with > 3 CL compared to 1 CL (P= 0.01) or 0 CL (P= 0.01). Suppression of CL development in programmed FET cycles was associated with a lower RHI compared with FETs in a natural cycle (P= 0.03). Angiogenic and non-angiogenic CPC numbers were lower in the absence of a CL in FETs (P= 0.02 and P= 0.04). Relaxin levels correlated with the number of angiogenic CPCs (r = 0.31; P= 0.03).
Maternal vascular health in early pregnancy is altered in women with aberrant numbers of CL, and might represent insufficient cardiovascular adaptation contributing to an increased risk of preeclampsia.