Association of Intralipid Infusions With Birth Outcomes and First-Trimester Placental Biomarkers in Frozen Embryo Transfer Cycles: A Retrospective Cohort Study.
- 1College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
- 2Repromed, Adelaide, South Australia, Australia.
Abstract
Background
Intralipid is used as an adjunctive therapy in assisted reproductive technology (ART), but data regarding pregnancy outcomes and early placental biomarkers are limited.Aims
To evaluate the association between Intralipid exposure during frozen embryo transfer (FET) cycles and pregnancy outcomes, birthweight and first-trimester placental biomarkers.Materials and methods
This retrospective cohort study included 729 women undergoing FET cycles resulting in delivery beyond 20 weeks at a private assisted reproduction clinic between 2017 and 2023. Outcomes were compared between women receiving intravenous Intralipid (n = 136) and those not receiving Intralipid (n = 593). Multivariable analyses adjusted for maternal age, body mass index, parity, plurality, foetal sex, cycle type, intracytoplasmic sperm injection (ICSI) use and preimplantation genetic testing for aneuploidy (PGT-A) status.Results
Individual pregnancy outcomes, including preterm birth, hypertensive disorders of pregnancy, gestational diabetes, foetal growth restriction, congenital anomalies and stillbirth, did not differ significantly between groups. Intralipid exposure was not independently associated with the composite adverse pregnancy outcome after adjustment (adjusted OR 2.08, 95% CI 0.73-5.96; p = 0.171). Intralipid-exposed pregnancies had lower first-trimester PAPP-A MoM values after adjustment (adjusted geometric mean ratio 0.86, 95% CI 0.76-0.98; p = 0.021), whereas PlGF and free β-hCG concentrations did not differ significantly. Lower PAPP-A concentrations were not associated with birthweight z-scores.Conclusions
Intralipid exposure was not independently associated with adverse pregnancy outcomes after adjustment. Pregnancies exposed to Intralipid had lower first-trimester PAPP-A measures without corresponding differences in other placental biomarkers or birthweight z-scores. Linkage of the Australia and New Zealand Assisted Reproduction Database with perinatal outcome registries, with routine capture of adjunctive ART therapies, would support more comprehensive maternal and neonatal safety evaluation.
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BibTeX
@article{kamal2026association,
title = {{Association of Intralipid Infusions With Birth Outcomes and First-Trimester Placental Biomarkers in Frozen Embryo Transfer Cycles: A Retrospective Cohort Study.}},
author = {Neerja Kamal and Richard Woodman and Kelton Tremellen},
journal = {The Australian \& New Zealand journal of obstetrics \& gynaecology},
year = {2026},
month = oct,
doi = {10.1111/ajo.70188},
url = {https://europepmc.org/article/MED/42902823},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Association of Intralipid Infusions With Birth Outcomes and First-Trimester Placental Biomarkers in Frozen Embryo Transfer Cycles: A Retrospective Cohort Study.
AU - Neerja Kamal
AU - Richard Woodman
AU - Kelton Tremellen
PY - 2026
DA - 2026/10/01
JO - The Australian & New Zealand journal of obstetrics & gynaecology
DO - 10.1111/ajo.70188
UR - https://europepmc.org/article/MED/42902823
AB - Background Intralipid is used as an adjunctive therapy in assisted reproductive technology (ART), but data regarding pregnancy outcomes and early placental biomarkers are limited.Aims To evaluate the association between Intralipid exposure during frozen embryo transfer (FET) cycles and pregnancy outcomes, birthweight and first-trimester placental biomarkers.Materials and methods This retrospective cohort study included 729 women undergoing FET cycles resulting in delivery beyond 20 weeks at a private assisted reproduction clinic between 2017 and 2023. Outcomes were compared between women receiving intravenous Intralipid (n = 136) and those not receiving Intralipid (n = 593). Multivariable analyses adjusted for maternal age, body mass index, parity, plurality, foetal sex, cycle type, intracytoplasmic sperm injection (ICSI) use and preimplantation genetic testing for aneuploidy (PGT-A) status.Results Individual pregnancy outcomes, including preterm birth, hypertensive disorders of pregnancy, gestational diabetes, foetal growth restriction, congenital anomalies and stillbirth, did not differ significantly between groups. Intralipid exposure was not independently associated with the composite adverse pregnancy outcome after adjustment (adjusted OR 2.08, 95% CI 0.73-5.96; p = 0.171). Intralipid-exposed pregnancies had lower first-trimester PAPP-A MoM values after adjustment (adjusted geometric mean ratio 0.86, 95% CI 0.76-0.98; p = 0.021), whereas PlGF and free β-hCG concentrations did not differ significantly. Lower PAPP-A concentrations were not associated with birthweight z-scores.Conclusions Intralipid exposure was not independently associated with adverse pregnancy outcomes after adjustment. Pregnancies exposed to Intralipid had lower first-trimester PAPP-A measures without corresponding differences in other placental biomarkers or birthweight z-scores. Linkage of the Australia and New Zealand Assisted Reproduction Database with perinatal outcome registries, with routine capture of adjunctive ART therapies, would support more comprehensive maternal and neonatal safety evaluation.
SN - 0004-8666
SN - 1479-828X
ER -