INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)  
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue XI November 2025  
Comparison of the Morphology and Morphometry of Placenta from  
Normal and Assisted Reproduction in Port Harcourt, Rivers State,  
Nigeria.  
Ibinabo Fubara Bob-Manuel* and Henry Ajulor Amadi-Ikpa  
Department of Anatomy, Faculty of Basic Medical Science, College of Health Sciences, University of  
Port Harcourt, Choba, Port Harcourt, Rivers State.  
*Corresponding Author  
DOI: https://dx.doi.org/10.51244/IJRSI.2025.12110144  
Received: 22 November 2025; Accepted: 28 November 2025; Published: 20 December 2025  
ABSTRACT  
The placenta is a fetomaternal organ which connects the developing fetus to the mother. This connection is both  
structural and functional. This study is aimed at examining the relationship between placental morphology and  
morphometry in normal and assisted reproduction (ART) in Port Harcourt, Rivers State, Nigeria. A case-  
controlled descriptive, prospective cross-sectional study was done using placentas from normal and assisted  
reproduction, with a sample size (n=96. The placenta was obtained immediately after delivery, and the  
membrane was trimmed off to expose the chorionic plate. Morphologic parameters were recorded, while  
measurements were taken for morphometric parameters. The means of placental morphometry were determined  
in normal and assisted reproduction. A statistically significant relationship (p< 0.05) was found to exist between  
morphometric parameters of the placenta in normal and assisted reproduction. At the confidence level (p< 0.05),  
all the morphometric parameters of the placenta, except the number of cotyledons and volume of placenta,  
showed a significant difference in normal and assisted reproduction. There was no statistically significant  
difference in the morphology of the placenta in normal and assisted reproduction, except for umbilical cord  
insertion. Assisted reproduction caused a significant effect on the morphometry of the placenta, umbilical cord  
insertion and feto-placental ratio. Our study showed that assisted reproduction increases the thickness and  
diameter of the placenta, but causes a reduction in placental weight and feto-placental ratio. ART increased the  
incidence of central and velamentous insertion but decreased eccentric and marginal insertion of the umbilical  
cord. Our study provides baseline data on morphometric parameters of the placenta in normal (spontaneous) and  
assisted production in Port Harcourt, Rivers State, Nigeria. These findings contribute to the global understanding  
of the dynamics of the effect of hormonal drugs used in ART.  
Key words: Morphology and Morphometry of Placenta, Normal (Spontaneous) Reproduction, Assisted  
Reproduction (ART).  
INTRODUCTION  
The placenta is a fetomaternal organ that establishes both the structural and functional connection between the  
developing fetus and the mother. Arising from the trophoectoderm at the point of implantation, it plays a central  
role in regulating intrauterine development and shaping individual susceptibility to chronic diseases in adulthood  
(1). The pre-implantation period represents a critical window during which epigenetic regulatory changes may  
occur, particularly in response to environmental influences associated with assisted reproduction technology.  
Such influences include controlled ovarian stimulation, in vitro fertilisation, embryo culture, selective embryo  
transfer, and hormonal priming, all of which differ significantly from the in vivo environment in oxygen  
concentration, temperature, cytokines, growth factors, and hormonal levels (2, 3). These differences may  
introduce stress to the gametes and early embryos, potentially resulting in alterations in placental cellular  
proliferation and fetal development.  
Page 1623  
www.rsisinternational.org  
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)  
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue XI November 2025  
The pre-implantation embryo is susceptible to environmental changes, making it prone to abnormalities in gene  
expression and developmental programming that can manifest as prenatal complications, postnatal disorders, or  
long-term diseases. Evidence indicates that the incidence of placenta previa and other placental abnormalities is  
significantly higher in pregnancies achieved through assisted reproduction compared to spontaneous conception  
(4, 5). Further studies have reported metabolic alterations, particularly within lipid pathways, in assisted  
reproduction pregnancies. Assisted reproduction has also been associated with increased placental growth  
dynamics mediated by alterations in the imprinting gene network, resulting in modified placental gene  
expression and signalling pathways (6). These molecular and structural changes contribute to variations in  
placental phenotype, morphology, and morphometry, particularly through effects on cell differentiation and  
growth of trophoblastic subpopulations such as glycogen cells, thereby influencing nutrient transport capacity  
and fetal well-being.  
Beyond its role in nutrient and gas exchange, the placenta functions as both an endocrine and immunological  
organ. It secretes a wide range of hormones that regulate maternal metabolism, physiology, and behaviour  
throughout pregnancy (7), and it plays a central role in coordinating the remodelling of maternal spiral arteries  
to ensure adequate uteroplacental perfusion (8, 9). Impairment of this remodelling process has been implicated  
in major obstetric complications collectively described as the “Great Obstetrical Syndromes,” including pre-  
eclampsia and fetal growth restriction (10). Additionally, maternal conditions such as diabetes mellitus and  
hypertension can significantly alter placental morphology and morphometry, thereby affecting fetal and maternal  
outcomes. At term, the typical human placenta is discoid in shape and measures approximately 20 centimetres  
in diameter, 2–3 centimetres in thickness, and about 500 grams in weight (11).  
Despite the importance of placental structure in clinical outcomes, limited research exists on the effects of  
assisted reproduction on placental morphology and morphometry in Port Harcourt, Rivers State. This study,  
therefore, aimed to evaluate the morphology and morphometric characteristics of placentas from normal and  
assisted reproduction pregnancies, and to investigate the relationships and comparative differences between  
these groups.  
Objectives  
1. To determine the morphologic and morphometric parameters of the placenta from spontaneous  
pregnancies.  
2. To determine the morphologic and morphometric parameters of the placenta in pregnancy from assisted  
reproductive techniques. (ART).  
3. To determine the effect of ART on the morphology and morphometry of the placenta.  
Justification  
The findings of the study will provide essential information on how normal and assisted reproductive  
pregnancies differ in placental morphology and morphometry. These insights will support developmental and  
reproductive anatomical scientists, clinical embryologists, forensic experts, and obstetricians and gynaecologists  
in improving fetal assessment, guiding clinical decision-making, and enhancing overall pregnancy management.  
LITERATURE REVIEW  
The development of the human placenta begins at the blastocyst stage with the formation of the trophectoderm,  
which differentiates into distinct trophoblast lineages through interactions with the maternal endometrium (12,  
13). The syncytiotrophoblast invades the maternal decidua and erodes maternal sinusoids, allowing maternal  
blood to fill the lacunae and establish early maternofetal circulation. Cytotrophoblasts proliferate to form  
primary, secondary, and tertiary villi, while extra-embryonic mesoderm and fetal blood vessels develop within  
the villous cores. Branching of tertiary villi produces free villi, and anchoring villi arise from cytotrophoblast  
contact with the decidua, forming the cytotrophoblastic shell (13, 14). As the chorionic villi expand to form the  
chorion frondosum, multiple villous structures merge into cotyledons, through which approximately 150  
millilitres of maternal blood per minute circulate. This arrangement supports efficient oxygen, nutrient, and  
Page 1624  
www.rsisinternational.org  
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)  
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue XI November 2025  
waste exchange, and the placenta, typically attached to the posterior uterine wall near the fundus, displays a  
granular maternal surface organised into 15–20 lobes called cotyledons (15).  
Placentation in vertebrates is understood to have evolved from pre-existing tissues such as the uterus and  
chorioallantoic membrane, despite vertebrates having a generally conserved body plan (16). As one of the most  
recently evolved organs, the placenta has arisen independently across various lineages, coinciding with multiple  
independent occurrences of viviparity, where embryos develop within the reproductive tract and are born live,  
rather than via egg-laying (17). In mammals, placentas are categorised based on fetal membranes into the  
choriovitelline and chorioallantoic types (18). The choriovitelline placenta, a vascularized trilaminar yolk sac,  
functions transiently post-implantation before regressing in most species except rodents and rabbits. The  
chorioallantoic placenta, derived from the trophectoderm and uterine endometrium, is the primary placental type  
in mid- to late gestation, showing diverse forms such as diffuse, multicotyledonary, zonary, and discoid or  
bidiscoid types depending on species morphology (19, 20).  
Microscopically, human placentation involves repeated branching of chorionic villi, producing a highly complex  
arborization pattern (21). This structural complexity is so extensive that even expert pediatric pathologists cannot  
reliably quantify it. As arborization mirrors the underlying fertility of the maternal environment, placental  
morphology directly reflects maternal health and influences fetal well-being (22). Possessing distinct maternal  
and fetal surfaces, the placenta serves as the primary interface for nutrient and gas exchange. Morphologic and  
morphometric indices correlate strongly with gestational age and birth weight, with placental morphometry and  
newborn sex demonstrating predictive value for birth outcomes (23). Aberrations in placental morphology  
accompany pregnancy complications; for instance, pre-eclampsia reduces placental weight, thickness, and  
diameter, all of which correlate with fetal growth and neonatal outcomes. Moreover, assisted reproduction has  
been associated with increased placental weight and feto-placental ratio compared to spontaneous pregnancies  
(24).  
Epidemiological evidence further suggests that events in intrauterine life influence long-term susceptibility to  
chronic disease (1, 25), as early development represents a critical biological window of heightened plasticity.  
Studies show that placental parameters correlate positively with birth weight, with male and female newborns  
exhibiting distinct mean values for placental weight, surface area, volume, and thickness. Additional findings  
reveal reduced placental thickness in pregnancy-induced hypertension and significantly diminished dimensions,  
including thickness and weight, in ART pregnancies compared with natural conception (15). Other reports  
document variations in normal placental weight ranges, alongside evidence that vascular abnormalities influence  
placental thickness and fetal size. Collectively, these findings underscore that ART pregnancies are consistently  
associated with reduced placental dimensions and altered morphology (15, 26).  
METHODOLOGY  
Study Design  
For the purpose of this study, the cross-sectional descriptive research design was employed to analyse and  
compare the morphological and morphometric characteristics of the placenta from normal and assisted  
reproduction in Port Harcourt, Rivers State, Nigeria.  
Study Area  
The study was conducted in Port Harcourt, Rivers State, Nigeria. Placental samples were obtained from  
spontaneous (natural) pregnancies and from pregnancies conceived through Assisted Reproductive Technology,  
provided they met the study’s inclusion criteria. The clinical facilities involved were the University of Port  
Harcourt Teaching Hospital and the Rivers State University Teaching Hospital.  
Sample Size Determination  
The sample size (n) was calculated using the formula:  
Page 1625  
www.rsisinternational.org  
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)  
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue XI November 2025  
푍2푃(1 − 푃)  
푛 =  
푑2  
Where:  
Z= Z-score of 1.96 for a 95% confidence interval.  
d= Precision or margin of error corresponding to the effect size of 0.1  
p= Expected population proportion taken as 0.5  
n= Sample size of 96  
METHODS OF DATA COLLECTION  
The study materials include; placenta collected following delivery for normal and assisted reproduction,  
measuring tape, weight scale, calibrated plastic bow, calibrated knitting needle and vernier calipers.  
The placenta was collected immediately after delivery, washed under running tap water and the fetal membrane  
trimmed off to expose the chorionic plate. Placenta was examined for completeness, and the morphologic  
parameters noted, including sharp consistency, colour and insertion of the umbilical cord. The morphometric  
parameters were measured as follows:  
(i) Weight: Then freshly collected placenta was placed on the plastic bow and weighed together with the plastic  
bow; the weight of both the placenta and the bow was recorded. The weight of the placenta was calculated by  
subtracting the weight of the plastic bow only from the weight of both the plastic bow and the placenta.  
(ii) Volume of Placenta: This was estimated by the water displacement method. A graduated plastic bucket was  
filled with water to the volume of two litres (2L). The placenta was then immersed into the bowl of water. The  
increase in volume which represented the volume of water displaced by the placenta was recorded as the volume  
of the placenta.  
(iii) Thickness of the Placenta: This was measured using a long-graduated knitting needle. The placenta was  
placed on a flat surface, and the needle was used to pierce through the placenta at three points; first at the centre,  
then at the margin and finally midway between the margin and the centre. The average of the three readings was  
calculated and recorded as the thickness of the placenta.  
(iv) Diameter of the Placenta: The diameter of the placenta was measured using a measuring tape. The  
maximum diameter representing the longest diameter was measured and recorded. The minimum diameter was  
also measured and recorded. The average of the two was taken as the diameter of the placenta.  
Figure 1: Photograph demonstrating the measurement of placental diameter.  
Page 1626  
www.rsisinternational.org  
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)  
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue XI November 2025  
Figure. 2: Photograph illustrating the measurements of Placental Diameter (Red Arrow Minimum Diameter,  
Blue Arrow Maximum Diameter)  
(v) Length of Umbilical Cord:  
This was measured with a measuring tape and recorded to the nearest  
centimetre.  
(vi)Thickness of the Umbilical Cord: This was measured with the aid of Vainer callipers and recorded to the  
nearest centimetres.  
Morphometric Indices  
These were calculated from the morphometric parameters obtained in this study.  
The indices include;  
(i) Surface Area of the placenta was calculated using the formula.  
minimum diameter  
surface area = π×maximum diameter  
×
2
2
π × R1 × R2  
=
2
Where π = 3.14 (constant)  
R1= = maximum diameter  
R2 = minimum diameter  
(ii) Feto-placental Ratio: This was determined by dividing the fetal weight by the placental weight.  
(iii) Circumference of the placenta: This was determined using the formula;  
푚푎푥푖푚푢푚 푑푖푎푚푒푡푒푟 + 푚푖푛푖푚푢푚 푑푖푎푚푒푡푒푟  
푝푙푎푐푒푛푡푎푙 푐푖푟푐푢푚푓푒푟푒푛푐푒 = 휋 ×  
2
Ethical Consideration  
This study received approval from the Research Ethics Committee of the University of Port Harcourt before its  
commencement.  
Page 1627  
www.rsisinternational.org  
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)  
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue XI November 2025  
RESULTS  
A paired sample (t-test) for comparison of mean morphometric parameters in normal and assisted reproduction  
in female and male fetuses, showed that all morphometric parameter except number of cotyledon and volume of  
placenta had statistical significant difference see table 1 and 2.  
Table. 1: paired sample statistics for females.  
PARAMETERS  
Mean  
Std.  
Std. Error t  
df  
Sig. (2-tailed) Inference  
Deviation Mean  
38.71  
35.80  
3.07  
1.03  
0.84  
0.25  
0.66  
1.00  
5.71  
0.86  
4.16  
0.38  
2.36  
0.52  
3.05  
2.95  
9.93  
0.10  
0.27  
0.06  
0.14  
0.11  
0.28  
0.16  
0.13  
0.04  
0.10  
0.16  
0.89  
0.13  
0.65  
0.06  
0.37  
0.08  
0.48  
0.46  
1.55  
0.01  
0.04  
0.01  
0.02  
0.02  
0.04  
5.36  
22.39  
0.99  
14.088  
7.743  
40  
0.000  
0.000  
0.556  
0.000  
0.000  
0.000  
0.000  
0.000  
0.000  
0.000  
0.968  
0.000  
Significant  
Significant  
Not Significant  
Significant  
Significant  
Significant  
Significant  
Significant  
Significant  
Significant  
Not Significant  
Significant  
Pair 1  
Pair 2  
Pair 3  
Pair 4  
Pair 5  
Pair 6  
Pair 7  
Pair 8  
Pair 9  
nGA  
aGA  
40  
40  
40  
40  
40  
40  
40  
40  
40  
40  
40  
nFBW  
aFBW  
nNCP  
2.23  
20.00  
20.54  
8.49  
-0.594  
-19.521  
-21.062  
-22.182  
-16.252  
-21.769  
4.562  
aNCP  
nDPMAX  
aDPMAX  
nDPMIN  
aDPMIN  
nDPAV  
aDPAV  
nLUC  
aLUC  
21.34  
7.38  
15.20  
7.93  
18.71  
14.16  
39.88  
0.33  
nTUC  
aTUC  
1.36  
0.59  
nWP  
0.49  
aWP  
0.61  
-24.717  
-0.04  
Pair 10 nTP  
aTP  
1.90  
432.80 34.30  
433.78 143.36  
Pair 11 nVP  
aVP  
49.40  
6.31  
-16.083  
Pair 12 nSAP  
Page 1628  
www.rsisinternational.org  
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)  
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue XI November 2025  
253.28 80.54  
12.58  
0.11  
0.15  
aSAP  
Pair 13 nFPR  
aFPR  
5.23  
4.68  
41  
0.69  
0.95  
3.048  
40  
0.004  
Significant  
N
Table 2: Paired sample statistics for males.  
PARAMETERS  
Mean  
Std.  
Std. Error t  
Mean  
df  
Sig. (2- Inference  
tailed)  
Deviation  
0.90  
0.82  
0.29  
0.46  
1.02  
5.74  
0.86  
4.72  
0.48  
2.90  
0.54  
2.95  
2.40  
9.69  
0.09  
0.25  
0.06  
0.12  
0.10  
0.19  
35.29  
Pair 1  
Pair 2  
Pair 3  
Pair 4  
Pair 5  
Pair 6  
Pair 7  
Pair 8  
Pair 9  
Pair 10  
Pair 11  
Page 1629  
nGA  
38.92  
35.88  
3.09  
0.13  
0.12  
0.04  
0.06  
0.14  
0.81  
0.12  
0.67  
0.07  
0.41  
0.08  
0.42  
0.34  
1.37  
0.01  
0.03  
0.01  
0.02  
0.01  
0.03  
4.99  
17.995  
12.676  
-3.146  
-22.997  
-21.212  
-29.022  
-18.846  
-28.543  
4.369  
49  
49  
49  
49  
49  
49  
49  
49  
49  
49  
49  
0.000  
0.000  
0.003  
0.000  
0.000  
0.000  
0.000  
0.000  
0.000  
0.000  
0.028  
Significant  
Significant  
Not Significant  
Significant  
Significant  
Significant  
Significant  
Significant  
Significant  
Significant  
Not Significant  
aGA  
nFBW  
aFBW  
nNCP  
aNCP  
nDPMAX  
aDPMAX  
nDPMIN  
aDPMIN  
nDPAV  
aDPAV  
nLUC  
aLUC  
nTUC  
aTUC  
nWP  
2.19  
19.88  
22.54  
8.18  
23.67  
7.33  
16.31  
7.76  
20.19  
14.20  
41.07  
0.33  
1.44  
0.59  
aWP  
0.51  
nTP  
0.57  
-42.266  
2.268  
aTP  
1.82  
nVP  
426.30  
www.rsisinternational.org  
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)  
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue XI November 2025  
aVP  
385.60  
47.18  
303.15  
5.25  
119.71  
6.23  
16.93  
0.88  
Pair 12  
Pair 13  
N
nSAP  
aSAP  
nFPR  
aFPR  
-21.211  
4.509  
49  
49  
0.000  
0.000  
Significant  
Significant  
84.61  
0.68  
11.97  
0.10  
4.41  
1.07  
0.15  
50  
Again, umbilical cord attachment showed a significant association with mode of conception, but no significant  
association was found with sex. See tables 3 and 4  
Table 3: Nature of Cord Attachment by sex in mode of conception  
Parameter  
Nature of Cord Attachment  
ꭕ2  
Inference  
df  
3
Conception  
Sex  
Central  
Eccentric  
Marginal  
Velamentous  
cal  
0.05  
female  
male  
1
30  
29  
16  
26  
17  
31  
15  
9
0
0
2
4
Not  
Significant  
3.46 7.81  
4.43 7.81  
Normal  
0
female  
male  
8
Not  
Significant  
3
Assisted  
11  
Table 4: Nature of Cord Attachment by Mode of Conception in males and females  
Parameter  
Sex  
Nature of Cord Attachment  
ꭕ2  
Inference  
df  
3
female  
normal  
central  
1
eccentric  
marginal  
velamentous  
cal  
0.05  
30  
16  
26  
29  
17  
15  
9
0
2
4
0
Significant  
Association  
11.4 7.81  
23.9 7.81  
Female  
assisted 8  
assisted 11  
Significant  
Association  
3
Male  
normal  
0
31  
The mean values for morphometric parameters in normal reproduction (spontaneous pregnancies) in female  
fetuses were observed as follows: number of cotyledons 20, maximum diameter 8.49cm, minimum diameter  
7.38cm, Average diameter 7.93cm, Cord length 14.16 Cord thickness 0.33cm, Placental weight 0.59kg, Placenta  
thickness 0.16cm and Volume of placenta 432.80cm3. The surface area of the placenta was recorded as 49.0cm2  
and the feto-placenta ratio 5.23. In a male fetus from normal reproduction, our findings for the means of  
morphometrics of placenta showed: number of cotyledons 19.88, maximum diameter 8.18cm, minimum  
diameter 7.33cm, Average diameter 7.76cm, Umbilical cord length 14.20cm, umbilical cord thickness 1.44cm,  
weight of placenta 0.59kg, Thickness of placenta 0.57cm, Volume of placenta 426.30cm. The mean surface area  
and feto-placental ratio were 47.18cm2 and 5.25, respectively.  
Page 1630  
www.rsisinternational.org  
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)  
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue XI November 2025  
For female fetuses in ART, the mean morphometric parameters were recorded as follows: number of cotyledons  
20.54, Maximum diameter 21.34cm, Minimum diameter 15.20cm, Average diameter 18.71cm, Length of  
umbilical cord 39.88cm, thickness of umbilical cord 1.36cm, Weight of placenta 0.49kg, Thickness of placenta  
1.90cm and Volume of placenta 433.78cm3. The means of surface area and fetomaternal ratio were 253.28cm2  
and 4.68. For male fetuses from ART, the mean values of morphometric parameters were shown as: number of  
cotyledon 22.54cm, Maximum diameter of placenta 23.67cm, Minimum diameter 16.31, Average diameter  
20.19cm, Length of umbilical cord 41.07cm, Thickness of umbilical cord 1.44cm, Weight of placenta 0.51kg,  
Thickness of placenta 1.82cm, Volume of placenta 385.60cm3. The mean of surface area and feto-placenta ratio  
were noted as 303.15cm2 and 4.41, respectively.  
DISCUSSION  
In the present study, the mean weight of the placenta in normal pregnancies for male and female fetuses was  
recorded at 590 grams (0.59 kg). This value is slightly higher than that reported by Begun et al. (27), which was  
417 grams for males and 407 grams for females. Our mean values align with the range reported by Balihallimath  
et al. (23), which indicated a mean placental weight between 400-1000 grams.  
Additionally, we measured the placental thickness and surface area, which were found to be 0.57 cm and 47.8  
cm², respectively. These measurements are relatively smaller than those recorded by Begun et al. (27), who  
reported a thickness of 2.04 cm and a surface area of 226.5 cm² for male fetuses. These discrepancies may be  
attributed to various environmental, social, and lifestyle factors associated with different geographical locations  
as well as the study periods. Differences in the level of obstetric care, which can affect the gestational age at  
delivery, may also play a role.  
Our findings indicate a statistically significant difference (p < 0.05) in all morphometric parameters of the  
placenta, except for the number of cotyledons and the placental volume in normal and assisted reproduction  
cases. Assisted reproductive technology (ART) led to an increase in placental thickness, diameter, and surface  
area. This is consistent with the report by Manna et al. (28), which showed that placentas from assisted  
reproduction have increased thickness and a higher incidence of hematoma compared to normal pregnancies.  
These changes may be influenced by environmental factors that cause epigenetic changes, thereby altering the  
imprinting gene network and impacting the phenotype. This could affect the development of trophoblastic cells,  
resulting in an increased number of cells and the deposition of metabolites and connective tissue in ART  
placentas. Furthermore, the hormonal drugs used during ART may contribute to these findings.  
It was observed in the present study that ART resulted in a reduction in placental weight and the feto-placental  
ratio. This contradicts the findings of Burton et al. (29) and Zhang et al. (6), who reported that placentas  
conceived through ART had greater weight and feto-placental ratios. The discrepancy might be due to a higher  
incidence of preterm deliveries in many IVF pregnancies, associated with complications of ART (24), which  
can lead to low birth weight, especially in cases of pre-eclampsia. Cochrane et al. (30) also noted that ART may  
be linked to various obstetric complications that require early and premature delivery of the fetus.  
Regarding umbilical cord characteristics, our findings indicated that ART increased both umbilical cord  
thickness and length. This is likely influenced by phenotypic changes caused by epigenetic environmental factors  
during the critical development period created by in vitro fertilisation and embryo transfer. However, no  
significant changes in the number of cotyledons or the volume of the placenta due to ART. This may be explained  
by the fact that the microscopic growth of the placenta involves repeated branching in the chorionic villi, which  
is dependent on the variable feto-placental environment, often described as "maternal soil" (31). The branching  
pattern of the chorionic villous tree determines the number and pattern of cotyledons because the cotyledons on  
the maternal surface of the placenta correspond to the position of the villous trees derived from the chorionic  
plate in the inter-villous space or blood chamber, as reported by Hupperts (32).  
Additionally, a significant correlation was observed between placental volume and diameter, which provides  
further insight into why ART did not result in any significant changes in placental volume. Regarding the  
morphology of the placenta, our study showed significant associations, especially concerning umbilical cord  
insertion types between ART and normal pregnancies for both male and female fetuses. ART was found to  
Page 1631  
www.rsisinternational.org  
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)  
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue XI November 2025  
increase the incidence of central and velamentous umbilical cord insertions while decreasing the occurrences of  
eccentric and marginal insertions. The increased incidence of central umbilical cord insertion aligns with  
findings from Yampolsky et al. (31). The abnormalities observed in our study may be explained by potential  
phenotypic changes arising from epigenetic environmental factors, which may have favoured different modes of  
umbilical cord insertion.  
CONCLUSION  
This study demonstrated a significant difference in all placental morphometric parameters, except for the number  
of cotyledons and placental volume (p < 0.05), between normal and assisted reproduction pregnancies, as well  
as a significant difference in umbilical cord attachment, although no significant variation was found in overall  
placental morphology. The findings contribute to global knowledge on how hormonal drug regimens used in  
assisted reproduction and the interval between in vitro fertilisation and embryo transfer influence embryo  
development and pregnancy outcomes, while also providing baseline data on placental morphology and  
morphometry in both groups.  
RECOMMENDATIONS  
Based on these findings, it is recommended that the interval between in vitro fertilisation and embryo transfer  
be reduced, hormonal treatment protocols for women undergoing assisted reproduction be optimised, and  
obstetric care for pregnancies achieved through assisted reproductive technology be strengthened to improve  
gestational age at delivery and overall pregnancy outcomes.  
Conflict Of Interest  
The authors declare that they have no conflict of interest regarding this publication.  
Data Availability  
The data supporting the findings of this study are available from the corresponding author upon reasonable  
request. All datasets have been anonymised to ensure confidentiality and comply with ethical requirements.  
REFERENCE  
01. Ceelen, M., Weissenbruch, M., Vermeden, P. W., Leeuwen, F. E., & Waal, H. A. D. (2008). Growth and  
development of children born after in vitro fertilisation. In Vitro Fertilization, 90(5), 1662–1673.  
02. Dong, J., Wen, L., Guo, X., Xiao, X., Jiang, F., Li, B., ... & Wang, X. (2019). The increased expression  
of glucose transporters in human full-term placentas from assisted reproductive technology without  
changes of mTOR signaling. Placenta, 86, 4-10.  
03. Sakka, S. D., Loutradis, D., Kanaka-Gantenbein, C., Margeli, A., Papastamataki, M., Papassotiriou, I.,  
& Chrousos, G. P. (2010). Absence of insulin resistance and low-grade inflammation despite early  
metabolic syndrome manifestations in children born after in vitro fertilization. Fertility and sterility,  
94(5), 1693-1699.  
04. Karami, M., Jenabi, E., & Fereidooni, B. (2018). The association of placenta previa and assisted  
reproductive techniques: a meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine, 31(14),  
1940-1947.  
05. Qin, J., Liu, X., & Wang, H., Gao, S. (2016). Assisted reproductive technology and risk of pregnancy-  
related Complications and adverse outcomes in singleton pregnancies: A meta-analysis of cohort studies.  
Fertility and Sterility, 105, 73–83.  
06. Xiang, M., Chen, S., Zhang, X., & Ma, Y. (2021). Placental diseases associated with assisted  
reproductive technology. Reproductive Biology, 21(2), 100505.  
07. Smith, R. (2022). The placenta as an endocrine organ/placental endocrinology. In F. Petraglia, M. Di  
Tommaso, & F. Mecacci (Eds.), Hormones and pregnancy: Basic science and clinical implications (pp.  
13–19). Cambridge University Press.  
Page 1632  
www.rsisinternational.org  
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)  
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue XI November 2025  
08. Burton, G. J., Fowden, A. L., & Thornburg, K. L. (2016). Placental origins of chronic disease.  
Physiological reviews, 96(4), 1509-1565.  
09. Smith, R., Paul, J. W., & Tolosa, J. M. (2020). Sharpey‐Schafer Lecture 2019: From retroviruses to  
human birth. Experimental Physiology, 105(4), 555-561.  
10. Brosens, I., Pijnenborg, R., Vercruysse, L., & Romero, R. (2011). The “Great Obstetrical Syndromes”  
are associated with disorders of deep placentation. American journal of obstetrics and gynecology,  
204(3), 193-201.  
11. Rathbun, K. M., & Hildebrand, J. P. (2022). Placenta abnormalities. In StatPearls. StatPearls Publishing  
12. Huang, C. C., Hsueh, Y. W., Chang, C. W., Hsu, H. C., Yang, T. C., Lin, W. C., & Chang, H. M. (2023).  
Establishment of the fetal-maternal interface: Developmental events in human implantation and  
placentation. Frontiers in Cell and Developmental Biology, 11, 1200330.  
13. Prabaharan, E., Armant, D. R., & Drewlo, S. (2025). Human placentation: foundations and implications  
for reproductive endocrinology and infertility. Systems biology in reproductive medicine, 71(1), 279-  
306.  
14. Knofler, M., Haider, S., Saleh, L., Pollheimer, J., Gamage, T. K., & James, J. (2019). Human placenta  
and trophoblast development: key molecular mechanisms and model systems. Cellular and Molecular  
Life Sciences, 76(18), 3479-3496.  
15. Ananthi, V., Rajkumar, D., & Muniappan, V. (2019). Morphometry of Human Placenta in Natural  
Conception and Assisted Reproduction with its Clinical Significance. Academia Anatomica  
International, 5(2), 42-45  
16. Griffith, O. W., & Wagner, G. P. (2017). The placenta is a model for understanding the origin and  
evolution of vertebrate organs. Nature ecology & evolution, 1(4), 0072.  
17. Kalinka, A. T. (2015). How did viviparity originate and evolve? Of conflict, co‐option, and cryptic  
choice. BioEssays, 37(7), 721-731.  
18. Furukawa, S., Kuroda, Y., & Sugiyama, A. (2014). A comparison of the histological structure of the  
placenta in experimental animals. Journal of toxicologic pathology, 27(1), 11-18.  
19. Benirschke, K., Kaufmann, P., & Baergen, R. N. (2000). Pathology of the human placenta (4th ed.).  
Springer.  
20. Charnock-Jones, D. S., Kaufmann, P., & Mayhew, T. M. (2004). Aspects of human fetoplacental  
vasculogenesis and angiogenesis. I. Molecular regulation. Placenta, 25(2-3), 103-113.  
21. Kaufmann, P., Huppertz, B., & Frank, H.-G. (2014). The placenta: Development, function, and  
pathology. In R. K. Creasy, R. Resnik, J. D. Iams, C. J. Lockwood, T. R. Moore, & M. F. Greene  
(Eds.), Creasy and Resnik's maternal-fetal medicine: Principles and practice (7th ed., pp. 55–73).  
Elsevier Saunders.  
22. Khong, T. Y. (2004, August). Placental vascular development and neonatal outcome. In Seminars in  
Neonatology, 9(4), 255-263. WB Saunders.  
23. Balihallimath, R. L., Shirol, V. S., Gan, A. M., Tyagi, N. K., & Bandankar, M. R. (2013). Placental  
morphometry determines birth weight and adulthood disease patterns. Journal of Clinical and Diagnostic  
Research, 7(2), 2428–2431.  
24. Wubale, Y., & Tolera, A. (2017). Gross morphological study of the placenta in pre-eclampsia mothers.  
Anatomy Journal of Africa, 6(2), 977–981.  
25. Huang, X., Mu, X., Deng, L., Fu, A., Pu, E., Tang, T., & Kong, X. (2019). The etiologic origins of  
chronic obstructive pulmonary disease. International journal of chronic obstructive pulmonary disease,  
1139-1158.  
26. Salmani, D., Purushothaman, S., Somashekara, S. C., Gnanagurudasan, E., Sumangaladevi, K.,  
Harikishan, R., & Venkateshwarareddy, M. (2014). Study of structural changes in placenta in pregnancy-  
induced hypertension. Journal of natural science, biology, and medicine, 5(2), 352.  
27. Begum Y, Fatima SA, Fatima SK. (2020). Role of Morphometry of Placenta in Determination of Birth  
Weight of Fetus in Hypertensive Mothers. Acad. Anat. Int. 2020;6(2):77-80.  
28. Manna, C., Lacconi, V., Rizzo, G., De Lorenzo, A., & Massimiani, M. (2022). Placental Dysfunction in  
Assisted Reproductive Pregnancies: Perinatal, Neonatal and Adult Life Outcomes. International Journal  
of Molecular Sciences, 23(2), 659.  
Page 1633  
www.rsisinternational.org  
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)  
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue XI November 2025  
29. Burton, G. J., Jauniaux, E., & Charnock-Jones, D. S. (2010). The influence of the intrauterine  
environment on human placental development. International Journal of Developmental Biology, 54(2),  
303.  
30. Cochrane, E., Pando, C., Kirschen, G. W., Soucier, D., Fuchs, A., & Garry, D. J. (2020). Assisted  
reproductive technologies (ART) and placental abnormalities. Journal of Perinatal Medicine, 48(8), 825-  
828.  
31. Yampolsky, M., Salafia, C. M., Shlakhter, O., Haas, D., Eucker, B., & Thorp, J. (2009). Centrality of the  
umbilical cord insertion in a human placenta influences the placental efficiency. Placenta, 30(12), 1058-  
1064.  
32. Huppertz, B. (2008). The anatomy of the normal placenta. Journal of Clinical Pathology, 61(12), 1296-  
1302.  
Page 1634  
www.rsisinternational.org