年轻恶性肿瘤患者行辅助生殖技术助孕结局  

Analysis of pregnancy outcomes anticancer therapy of young women with assisted reproduction technology after malignant tumors surgery

作　　者：李静[1] 乔洪武[1] 任炳楠 杜明泽 张俊韦 管一春[1] LI Jing;QIAO Hongwu;REN Bingnan;DU Mingze;ZHANG Junwei;GUAN Yichun(The Third Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province,450052)

机构地区：[1]郑州大学第三附属医院,450052

出　　处：《中国计划生育学杂志》2022年第10期2309-2315,共7页Chinese Journal of Family Planning

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210461);国家自然科学基金(81904291)。

摘　　要：目的:探讨有生育需求的年轻女性恶性肿瘤患者抗肿瘤治疗后接受辅助生殖技术的助孕结局及对子代安全性的影响.方法:2015年1月-2020年12月在本院行体外受精/单精子显微注射(IVF/ICSI)-胚胎移植(ET)的恶性肿瘤患者34例设为观察组;根据其年龄、体重指数(BMI)、基础卵泡刺激素(FSH)、窦卵泡数(AFC)、取卵时间按1􀏑3标准采用倾向性评分方法匹配对照组(102例).比较助孕结局.结果:观察组较对照组使用促性腺激素(Gn)天数短[(11.1±3.0)d比(11.5±2.4)d,P=0.014]、注射绒毛膜促性腺激素(hCG)日黄体生成素(LH)水平高[(5.9±2.7)U比(3.2±2.6)U,P=0.048]、获卵数少[(11.5±9.47)枚比(11.8±6.7)枚,P=0.042]、受精率低(76.5%比83.5%,P=0.006),优胚率高(58.5%比49.7%,P=0.041),其他指标差异无统计学意义(P>0.05).观察组首次移植的胚胎数多于对照组[(1.7±0.3)枚比(1.4±0.5)枚,P=0.049],但首次移植胚胎来源及类型、临床妊娠率、种植率差异无差异(P>0.05);观察组达妊娠时间显著长于对照组[(203.9±149.5)d比(123.4±62.4)d,P=0.000],每活产需要的取卵周期数(2.7比1.9,P=0.030)、移植周期数(2.9比2.2,P=0.004)、胚胎数均大于对照组(4.6枚比3.3枚,P=0.006);而累积妊娠率、累积活产率、每活产需要的优质胚胎数均无差异(P>0.05);分娩方式、分娩孕周、胎儿出生体重、孕期并发症发生率均无差异(P>0.05).结论:辅助生殖技术能满足年轻女性恶性肿瘤患者术后的生育需求.Objective: To explore the outcomes of young women who wanted pregnancy and had undergone assisted reproductive after treatment of their malignant tumors, and to study its impact on the safety of the off-springs of these women. Methods: The women with malignant tumors who had undergone in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI) and embryo transfer(ET) were selected in study group from January 2015 to December 2020. The women in control group were matched using the propensity scoring method in a 1:3 ratio of the women in the study in accordance with the age, body mass index(BMI), and basic follicle stimulating hormone(FSH), the number of antral follicles(AFC), and the egg retrieval time. The pregnancy outcomes and the off-springs safety of the women were compared between the two groups. Results: The days of gonadotropin(Gn) used(11.1±3.0 d) of the women in the study group was significantly shorter than that(11.5±2.4 d) of the women in the control group(P=0.014). The level of luteinizing hormone(LH) of the women in the study group(5.9±2.7 U) on the hormone of chorionic gonadotropin(hCG) injection day was significantly higher than that(3.2±2.6 U) of the women in the control group(P=0.048). The number of eggs retrieved(11.5±9.47) of the women in the study group was significantly less than that(11.8±6.7) of the women in the control group(P=0.042). The fertilization rate(76.5%) of the women in the study group was significantly lower than that(58.5%)of the women in the control group(P=0.006).The rate of quality of embryo(58.5%)of the women in the study group was significantly higher than that(49.7%)of the women in the control group(P=0.041).There were no significant differences in the values of other indicators of the women between the two groups(P>0.05).The number of embryos in the first time of transferred(1.7±0.3)of the women in the study group was significantly higher than that(1.4±0.5)of the women in the control group(P=0.049),but there were no significant differences in the source and

关 键 词：生育需求 恶性肿瘤 辅助生殖技术 妊娠结局 病例对照研究 

分 类 号：R714.8[医药卫生—妇产科学]