Placentation and complications of ART pregnancy. An update on the different possible etiopathogenic mechanisms involved in the development of obstetric complications

• Published in: Journal of reproductive immunology Vol. 162; p. 104191
• Main Authors: Galanti, Francesco, Riccio, Serena, Giannini, Andrea, D’Oria, Ottavia, Buzzaccarini, Giovanni, Scudo, Maria, Muzii, Ludovico, Battaglia, Francesco Antonino
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.03.2024
• Subjects: ICSI; Implantation failure; IVF techniques; Maternal cardiovascular adaptation; Placentation; ICSI; Maternal cardiovascular adaptation; IVF techniques; Placentation; Implantation failure
• ISSN: 0165-0378; 1872-7603
• DOI: 10.1016/j.jri.2023.104191

Infertile couples’ percentage is increasing all over the world, especially in Italy, with high number of children born in our country through assisted reproductive techniques (ART). However, pregnancies obtained by ART have increased potential obstetrical risks which could be caused by fetus-placenta unit development, most of all due to placentation’s evolution. These can be reassumed into miscarriage, chromosomal abnormalities, preterm delivery, multiple pregnancy, IUGR, placenta previa, abruptio placentae, preeclampsia and hypertensive disorders, postpartum hemorrhage. The aim of this article is to evaluate hypothetic mechanism involved in placentation process and in the etiopathology of ART pregnancies disorders, giving an updating overview of different etiopathogenetic pathways and features. On this scenario, we create an updated review about the etiopathogenesis of abnormal placentation in ART pregnancies. Several features and different etiopathogenetic characteristic might impact differently such as advanced maternal age, poor ovarian reserve, oocyte quality and causes of subfertility themselves, and the ART techniques itself, as hormonal medical treatments and laboratory techniques such as gamete and embryo laboratory culture, cryopreservation versus fresh ET, number of embryos transferred. To further explore the molecular mechanisms behind placentation in ART pregnancies, further studies are necessary to gain a better understanding of the various aspects involved, particularly those which are not fully comprehended. This could prove beneficial to clinicians in both ART care and obstetric care, as it could help to stratify obstetrical risk and decrease complications in women undergoing ART, as well as perinatal disorders in their children. Correct placentation is essential for a successful pregnancy for both mother and baby. •Rising infertility has led to increased assisted reproductive techniques (ART) use, but also increased obstetrical risks.•The study examines the mechanisms in placentation and ART pregnancy disorders through an updated review of etiopathogenesis.•Factors such as maternal age and oocyte quality can uniquely impact the outcome of ART pregnancies.•The techniques and methods used in ART, such as hormonal treatments and embryo culture, can affect pregnancy outcomes.•Further studies are needed to explore molecular mechanisms behind placentation in ART pregnancies.