Ziya Kalem,MD Gurgan Clinic IVF and Women Health Center THE EFFECT OF PROGESTERONE USAGE IN THE FIRST TRIMESTER ON FETAL NUCHAL TRANSLUCENCY Ziya Kalem,MD Gurgan Clinic IVF and Women Health Center

N:3716 Progesterone could might cause abnormal blood flow patterns and, subsequently, increased NT This increase in NT do not affect the screening test results

The increase in NT was only in the week 11 and did not include weeks 12 and 13 . Different preparations and usages might render the evaluation unhealthy. Bleeding in the progesterone group with the risk of miscarriage might change fetal circulation and have an impact on NT.

N=192 Conclusions: We think that oral progesterone therapy may increase NT depending on treatment duration without causing abnormal prenatal screening test results.

Objective: This study aims at investigating how the first-trimester progesterone treatment affects nuchal translucency. Study Design: March 2015- February 2016 Live birth* N=285 Gestational age:11.0-13.6 w CRL:41-84mm The study group(n=121) was composed of the patients who became pregnant with ART in a private IVF clinic and whose pregnancies were monitored; these patients used intravaginal progesterone 180 mg/day (Crinone gel; Serono, Istanbul, Turkey) until gestational week 12 as applied in the monitoring of all ART pregnancies. The control group(n=164) was composed of the pregnant women who became pregnant spontaneously without using any progesterone preparation in the first trimester.

Exclusion Criteria: High risk in screening test NT>2.5mm Congenital anomalies or chromosomal anomalies were detected in amniocentesis or in the monitoring Systemic disorders such as diabetes and hypertension Multiple pregnancy Bleeding in the first trimester

Relationship between fetal NT measurement and maternal and fetal parameters

No statistically significant difference was found between the two groups by whether they are smokers (0.558). The rate of non-smokers was 95.7% in the non-progesterone group while the rate was found to be 94.2% in the progesterone group. No statistically significant difference was found between the two groups by the presence/lack of nasal bone (0.463). The rate of presence of nasal bone was 93.9% in the non-progesterone group while the rate was found to be 95.9% in the progesterone group. No statistically significant relationship was found between the NT parameter and whether the mother is a smoker and the presence/lack of nasal bone (p=0.579 and p=0.950 respectively).

When all variables were included in the ROC curve analysis, it was demonstrated that only NT (AUC: 0.585, p = 0.014, 95% CI: 0.517–0.654) was discriminative factor for women in progesterone treatment group

Conclusion: It was seen in our study that NT values were higher in the first-trimester progesterone group than in the non-progesterone group. This data needs to be confirmed by future studies which will be carried out with wider groups of patients so it can be reflected onto prenatal screening tests.