Determination of risk factors for osteopenic changes in women pregnant using assisted reproductive technologies
DOI:
https://doi.org/10.63341/bmbr/1.2025.60Keywords:
bone density, biochemical markers, hormonal profile, intrauterine insemination, oocyte donationAbstract
The study aimed to investigate the factors that influence the risk of osteopenic changes in women who became pregnant with the help of assisted reproductive technologies. The study involved 150 women aged 25-40 who became pregnant after in vitro fertilisation, intrauterine insemination and oocyte donation. Bone mineral density was assessed by ultrasound densitometry in the distal forearm at the early (8-12 weeks) and late (32-36 weeks) stages of pregnancy. The T-score values showed a significant decrease in the third trimester in all groups, the largest – in patients who became pregnant due to oocyte donation (-1.3 ± 0.3 in the distal forearm). An analysis of socio-demographic characteristics revealed that age over 35, low physical activity, vitamin D and calcium deficiency, and bad habits such as smoking and excessive caffeine consumption significantly increased the risk of developing osteopenic changes. Women with regular consumption of dairy products, calcium supplements and a normal level of physical activity had significantly better
bone mineral density. Biochemical markers confirmed higher levels of calcium, magnesium and vitamin D in the oocyte donation group, while the intrauterine insemination group demonstrated a deficiency of these elements and increased markers of bone resorption. The hormonal profile also had a significant impact on bone health: high oestrogen levels in the oocyte donation group were associated with less severe osteopenic changes, while elevated parathyroid hormone levels in the intrauterine insemination group contributed to increased bone loss. Patients with the highest levels of prolactin had better bone mineral density preservation due to the positive effect of this hormone on calcium metabolism. The findings emphasise the need for comprehensive monitoring of bone health in women who have become pregnant using assisted reproductive technologies
Received: 10.09.2024 | Revised: 15.11.2024 | Accepted: 25.02.2025
References
Deinichenko O, Sіusіuka V, Krut Y, Pavlyuchenko M, Kyryliuk O, Boguslavska N. Prediction of the development of fetal growth retardation in pregnant women with chronic arterial hypertension. Reprod Health Woman. 2022;7:14–20. DOI: 10.30841/2708-8731.7.2022.272466
Tsymbal A, Kotlova Y. Assessment of risk factors for osteopenia development in premature babies. Mod Med Technol. 2023;4:27–36. DOI: 10.34287/mmt.4(59).2023.4
Zhytnik L, Maasalu K, Duy BH, Pashenko A, Khmyzov S, Reimann E, et al. De novo and inherited pathogenic variants in collagen‐related osteogenesis imperfecta. Mol Gen Genomic Med. 2019;7(3):e559. DOI: 10.1002/mgg3.559
Stern JE, Luke B, Tobias M, Gopal D, Hornstein MD, Diop H. Adverse pregnancy and birth outcomes associated with underlying diagnosis with and without assisted reproductive technology treatment. Fertil Steril. 2015;103(6):1438–45. DOI: 10.1016/j.fertnstert.2015.02.027
Wang Y, Chen L, Tao Y, Luo M. Risk factors of ectopic pregnancy after in vitro fertilization-embryo transfer in Chinese population: A meta-analysis. PLoS ONE. 2024;19(1):e0296497. DOI: 10.1371/journal.pone.0296497
Nørgård BM, Catalini L, Jølving LR, Larsen MD, Friedman S, Fedder J. The efficacy of assisted reproduction in women with a wide spectrum of chronic diseases – a review. Clin Epidemiol. 2021;13:477–500. DOI: 10.2147/clep.s310795
Graham ME, Jelin A, Hoon AH, Floet AMW, Levey E, Graham EM. Assisted reproductive technology: Short‐ and long‐term outcomes. Dev Med Child Neurol. 2022;65(1):38–49. DOI: 10.1111/dmcn.15332
Sun B, Li L, Zhang Y, Wang F, Sun Y. Pregnancy outcomes in women with primary ovarian insufficiency in assisted reproductive technology therapy: A retrospective study. Front Endocrinol. 2024;15:1343803. DOI: 10.3389/fendo.2024.1343803
Kyiv Perinatal Centre [Internet]. [cited 2024 August 7]. Available from: https://www.perinatalcenter.com.ua/en/
The World Medical Association. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects [Internet]. [cited 2024 August 7]. Available from: https://www.wma.net/what-we-do/medical-ethics/declaration-of-helsinki/
IBM. SPSS Statistics [Internet]. [cited 2024 August 7]. Available from: https://www.ibm.com/products/spss-statistics
Vohra G, Rajendran N, Kumari A. Association of mineral metabolism biomarkers in patients with chronic kidney disease and renal transplant recipients: A single-centre prospective study. Int J Med Med Res (IJMMR). 2024;10(2):57–64. DOI: 10.61751/ijmmr/2.2024.57
Golombok, S. Assisted reproductive technologies. In: The SAGE encyclopedia of lifespan human development. Thousand Oaks, CA: SAGE Publications, Inc.; 2018. P. 162–3. DOI: 10.4135/9781506307633.n65
Berg K, Whitehead K. Pregnancy associated osteoporosis. Practising Midwife. 2024;27(5):35–8. DOI: 10.55975/chwn3013
Butscheidt S, Tsourdi E, Rolvien T, Delsmann A, Stürznickel J, Barvencik F, et al. Relevant genetic variants are common in women with pregnancy and lactation-associated osteoporosis (PLO) and predispose to more severe clinical manifestations. Bone. 2021;147:115911. DOI: 10.1016/j.bone.2021.115911
Anagnostis P, Lampropoulou-Adamidou K, Bosdou JK, Trovas G, Galanis P, Chronopoulos E, et al. Comparative effectiveness of therapeutic interventions in pregnancy and lactation-associated osteoporosis: A systematic review and meta-analysis. J Clin Endocrinol Metab. 2023;109(3):879–901. DOI: 10.1210/clinem/dgad548
Carsote M, Turturea MR, Valea A, Buescu C, Nistor C, Turturea IF. Bridging the gap: Pregnancy- and lactation-associated osteoporosis. Diagnostics. 2023;13(9):1615. DOI: 10.3390/diagnostics13091615
Lee S, Hong N, Kim KJ, Park CH, Lee J, Rhee Y. Bone density after teriparatide discontinuation with or without antiresorptive therapy in pregnancy- and lactation-associated osteoporosis. Calcif Tissue Int. 2021;109:544–53. DOI: 10.1007/s00223-021-00869-6
Fukushima M, Kawajiri M, Yoshida M, Takeishi Y, Nakamura Y, Yoshizawa T. Prevalence of pregnancy- and lactation-associated osteoporosis in the postpartum period: A systematic review and meta-analysis. Drug Discoveries Ther. 2024;18(4):220–8. DOI: 10.5582/ddt.2024.01037
Mishra N, Masroor H, Gupta M. Osteoporosis in pregnant and lactating females: An update. Turk J Osteoporos. 2024;30(1):1–15. DOI: 10.4274/tod.galenos.2023.24392
Morato ALC, Verruma CG, Furtado CLM, Reis RMD. In vitro maturation of oocytes: What is already known? Biol Reprod. 2024;112(2):18–30. DOI: 10.1093/biolre/ioae147
Maehara K, Iwata H, Kimura K, Mori E. Experiences of transition to motherhood among pregnant women following assisted reproductive technology: A qualitative systematic review. JBI Evidence Synth. 2021;20(3):725–60. DOI: 10.11124/jbies-20-00545
Ottun TA, Adewunmi AA, Olumodeji AM, Jinadu FO. Factors associated with clinical pregnancy following assisted reproductive technology: A comparative cross-sectional study. J West Afr Coll Surg. 2024;15(1):37–43. DOI: 10.4103/jwas.jwas_148_23
Qian Y, Wang L, Yu L, Huang W. Pregnancy- and lactation-associated osteoporosis with vertebral fractures: A systematic review. BMC Musculoskeletal Disord. 2021;22:926. DOI: 10.1186/s12891-021-04776-7
Lampropoulou-Adamidou K, Trovas G, Triantafyllopoulos IK, Yavropoulou MP, Anastasilakis AD, Anagnostis P, et al. Teriparatide treatment in patients with pregnancy- and lactation-associated osteoporosis. Calcif Tissue Int. 2021;109:554–62. DOI: 10.1007/s00223-021-00871-y
Basma H, Dbouk S, Issa Z. Pregnancy and lactation associated osteoporosis: A case report. Front Med Case Rep. 2023;4(5):1–8. DOI: 10.47746/fmcr.2023.4503
Cheng CH, Chen LR, Chen KH. Osteoporosis due to hormone imbalance: An overview of the effects of estrogen deficiency and glucocorticoid overuse on bone turnover. Int J Mol Sci. 2022;23(3):1376. DOI: 10.3390/ijms23031376
Wu P, Sharma GV, Mehta LS, Chew‐Graham CA, Lundberg GP, Nerenberg KA, et al. In‐hospital complications in pregnancies conceived by assisted reproductive technology. J Am Heart Assoc. 2022;11(5). DOI: 10.1161/jaha.121.022658
Miles B, Panchbhavi M, Mackey JD. Analysis of fracture incidence in 135 patients with pregnancy and lactation osteoporosis (PLO). Cureus. 2021;13(10):e19011. DOI: 10.7759/cureus.19011
Kaneuchi Y, Iwabuchi M, Hakozaki M, Yamada H, Konno SI. Pregnancy and lactation-associated osteoporosis successfully treated with romosozumab: A case report. Medicina. 2022;59(1):19. DOI: 10.3390/medicina59010019
Ferreira DA, Taborda F, Mendonça T, Farinha F. Pregnancy and lactation-associated osteoporosis in a Systemic Lupus Erythematosus patient. Lupus. 2022;31(14):1829–33. DOI: 10.1177/09612033221136102
Abdulrazaq AA, Ainsworth AJ, Britton JW, Shenoy CC, Babayev SN, Cascino GD, et al. Seizure control in women with epilepsy undergoing assisted reproductive technology. Epilepsia. 2023;64(10):e207–13. DOI: 10.1111/epi.17748
Cohen A, Kamanda-Kosseh M, Dempster DW, Zhou H, Müller R, Goff E, et al. Women with pregnancy and lactation-associated osteoporosis (PLO) have low bone remodeling rates at the tissue level. J Bone Miner Res. 2019;34(9):1552–61. DOI: 10.1002/jbmr.3750
Rahimi M, Daneshvar S, Khabbazi A. Pregnancy‐associated osteoporosis following in vitro fertilization: A case report. Clin Case Rep. 2024;12(3):e8702. DOI: 10.1002/ccr3.8702
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