Number of embryos transferred and diagnosis of preeclampsia
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Multiple births and first pregnancy are associated with higher preeclampsia risk. It is unknown if the transfer of multiple embryos or first embryo transfer with assisted reproductive technology (ART) is also associated with greater preeclampsia risk. The increased rate of preeclampsia among twin births compared with singletons may be due to a larger placental mass or relative placental ischemia in twin gestations compared with singletons. The transfer of multiple embryos often results in twins, but it is unknown if the transfer of multiple embryos increases the risk of preeclampsia.

Considering all singleton births, the transfer of multiple embryos increased the risk of preeclampsia. Relative risks were greatest for fresh non-donor cycles. Vanishing twin and number of prior ART cycles was not associated with preeclampsia among singleton births, respectively. Considering all twin births, the transfer of more than 2 embryos increased the risk of preeclampsia. Vanishing triplets and number of prior ART cycles were not associated with preeclampsia among twin births, respectively.

The policy of single embryo transfer, in addition to its known reduction in multiple births and prematurity, may also reduce preeclampsia risk. Given the increasing trend toward performing cryopreserved embryo transfers, it is relevant that researchers did not find that transferring more cryopreserved embryos was correlated to preeclampsia diagnosis. Understanding how increasing single embryo transfer, in addition to its known reduction in multiple births and prematurity, may also reduce the risk for preeclampsia, is important for patient and provider awareness and care delivery policies.

Source: https://rbej.biomedcentral.com/articles/10.1186/s12958-020-00627-7
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