OBJECTIVE To investigate associations between assisted reproductive technology (ART) -induced alterations in corpus luteum (CL) number during implantation, and maternal pregnancy and birth outcomes. Pregnancies conceived through ART are associated with increased risks of adverse obstetric and perinatal outcomes, with discrepancies in outcomes between different ART treatment protocols. We hypothesize this is due to the periconceptional hormonal environment regulated by the CL. ART protocols affect CL quantity at conception resulting in CL absence or a supraphysiological number of CL. DESIGN This study is embedded in the Rotterdam Periconceptional Cohort, an ongoing tertiary center prospective cohort at the Erasmus University Medical Center in Rotterdam, the Netherlands. SUBJECTS Women with a singleton pregnancy with data on CL. EXPOSURE The number of CL, based on mode of conception: 0 CL (artificial cycle frozen embryo transfer (AC-FET), n=72); >1 CL (ovarian stimulated fresh embryo transfer, n=462) and 1 CL (natural cycle frozen embryo transfer (NC-FET) and natural conceptions, n=1327). MAIN OUTCOME MEASURES Hypertensive disorders of pregnancy, gestational diabetes, gestational age at birth and birthweight, derived from medical records. RESULTS We included 1,861 pregnancies. The results were adjusted for maternal age, maternal body mass index, nulliparity and obstetric history. In comparison with natural conceptions (1 CL), a pregnancy with CL absence (0 CL) was associated with a higher risk of gestational diabetes (aOR 2.59 [95% CI 1.31;5.15]), and a higher risk of preeclampsia, albeit non-significantly (aOR 2.02 [95% CI 0.91;4.51]). In comparison with pregnancies with >1 CL the risk of preeclampsia was significantly lower (aOR 0.36 [95% CI 0.18;0.72]). Post hoc analyses revealed that in male neonates, >1 CL was associated with a lower birthweight percentile (aβ -6.18 [95% CI -11.16;-1.20]). In contrast, female neonates showed no association with >1 CL, whereas CL absence was associated with a higher birthweight percentile (aβ 12.93 [95% CI 2.52;23.34]). CONCLUSION Risks of hypertensive disorders of pregnancy, gestational diabetes and relative birthweight differ between CL groups. These findings support the hypothesis that an aberrant number of CL impacts maternal pregnancy and or birth outcomes. Additional studies need to be conducted to investigate causes and underlying pathophysiology.

中文翻译：

---

黄体数量对孕产妇妊娠和分娩结局的影响：鹿特丹围孕期队列。


目的 探讨辅助生殖技术 （ART） 诱导的着床过程中黄体 （CL） 数量改变与孕产妇妊娠和分娩结局之间的关联。通过 ART 受孕的妊娠与不良产科和围产期结局的风险增加有关，不同 ART 治疗方案之间的结局存在差异。我们假设这是由于 CL 调节的围孕期荷尔蒙环境。ART 方案会影响受孕时的 CL 数量，导致 CL 缺失或 CL 的超生理数量。设计 本研究嵌入鹿特丹围孕期队列，这是一个正在进行的三级中心前瞻性队列，位于荷兰鹿特丹伊拉斯谟大学医学中心。受试者 具有 CL 数据的单胎妊娠妇女。暴露 基于受孕方式的 CL 数量： 0 CL（人工周期冷冻胚胎移植 （AC-FET），n=72）;>1 CL （卵巢刺激的新鲜胚胎移植，n=462） 和 1 CL （自然周期冷冻胚胎移植 （NC-FET） 和自然受孕，n=1327）。主要结局指标 妊娠期高血压疾病、妊娠糖尿病、出生胎龄和出生体重，来自病历。结果我们纳入了 1,861 例妊娠。根据产妇年龄、产妇体重指数、未产妇和产科病史对结果进行调整。与自然受孕 （1 CL） 相比，无 CL 的妊娠 （0 CL） 与妊娠糖尿病风险较高相关 （aOR 2.59 [95% CI 1.31;5.15]），以及子痫前期的风险更高，尽管不显著 （aOR 2.02 [95% CI 0.91;4.51]）。与 >1 CL 的妊娠相比，子痫前期的风险显著降低 （aOR 0.36 [95% CI 0.18;0.72]). 事后分析显示，在男性新生儿中，>1 CL 与较低的出生体重百分位数相关 （aβ -6.18 [95% CI -11.16;-1.20]）。相比之下，女性新生儿与 >1 CL 无关，而 CL 缺失与较高的出生体重百分位数相关 （aβ 12.93 [95% CI 2.52;23.34]）。结论 妊娠高血压疾病、妊娠糖尿病和相对出生体重的风险在 CL 组之间有所不同。这些发现支持了 CL 数量异常会影响孕产妇妊娠和/或分娩结局的假设。需要进行更多研究来调查病因和潜在的病理生理学。