Diminished ovarian reserve linked to pre-eclampsia, placental vascular lesions

Among pregnant women who conceived via in vitro fertilization (IVF), diminished ovarian reserve appears to contribute to a higher incidence of pre-eclampsia and multiple placental vascular lesions of foetal origin, as reported in a study.

Researchers looked at the medical records of women with live singleton births after IVF. They compared obstetric outcomes and placental findings between women with diminished ovarian reserve (antral follicle count of no more than six; DOR group, n=110) and those without the condition (antral follicle count of at least seven; control group, n=772).

The primary endpoints were placental findings, including anatomic, inflammatory, vascular malperfusion, and villous maturation lesions, as defined according to the Amsterdam Placental Workshop Group Consensus. Secondary outcomes included obstetric and perinatal outcomes.

Compared with those in the control group, women in the DOR group were older (mean age 36.3 vs 35.3 years; p=0.02), more likely to have endometriosis (p=0.02), and less likely to have ovulation disorder (p<0.001), tubal factor (p=0.04), or a transfer of a blastocyte (p=0.007).

Multivariable logistic regression analyses revealed that DOR was associated with greater odds of pre-eclampsia (8.1 percent vs 2.7 percent; adjusted odds ratio [aOR], 3.05, 95 percent confidence interval [CI], 1.33–6.97), foetal vasculopathy (p=0.01), and multiple foetal vascular malperfusion lesions (p=0.03).

However, DOR was associated with lower rates of circummarginate insertion (p=0.01) and intervillous thrombosis (p=0.02).