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人类免疫缺陷病毒1型血清学不一致的夫妇经卵胞浆内单精子注射体外受精后的产科结局

Obstetric outcomes of human immunodeficiency virus-1-serodiscordant couples following in vitro fertilization with intracytoplasmic sperm injection.

作者信息

Cleary-Goldman Jane, Peña Joseph E, Thornton Melvin H, Robinson Julian N, D'Alton Mary E, Sauer Mark V

机构信息

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, New York Presbyterian Medical Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA.

出版信息

Am J Perinatol. 2003 Aug;20(6):305-11. doi: 10.1055/s-2003-42694.

Abstract

The objective of this article is to report obstetric outcomes of human immunodeficiency virus-1 (HIV-1)-serodiscordant couples who underwent in vitro fertilization and embryo transfer (IVF-ET) with intracytoplasmic sperm injection (ICSI) at a tertiary care center. We reviewed the outcomes of seronegative women after IVF-ET with ICSI from January 1, 1997 to June 1, 2002. Serodiscordant couples (n = 25) successfully conceived 27 pregnancies delivering 40 neonates (16 singletons, 9 twins, and 2 triplets). The mean gestational age at delivery was 37 0/7 weeks +/- 3 6/7 weeks (range 26 0/7 to 41 2/7 weeks). The mean birth weight was 2646 g +/- 952 g (range 678 to 4396 g). The cesarean section rate was 70%. Preterm delivery (<37 weeks) occurred in 7 pregnancies, and low birth weight (<2500 g) was observed in 8 pregnancies. There were no HIV-1 seroconversions detected at delivery. One hundred percent of the mothers and offspring were beyond 3 months postpartum and remained seronegative. IVF-ET with ICSI seems safe and effective for serodiscordant couples. Obstetric outcomes are favorable, and HIV-1 infection risk is limited.

摘要

本文的目的是报告在一家三级医疗中心接受体外受精和胚胎移植(IVF-ET)并进行卵胞浆内单精子注射(ICSI)的人类免疫缺陷病毒1型(HIV-1)血清学不一致夫妇的产科结局。我们回顾了1997年1月1日至2002年6月1日期间接受ICSI的IVF-ET后血清学阴性女性的结局。血清学不一致夫妇(n = 25)成功受孕27次,分娩40名新生儿(16名单胎、9对双胞胎和2组三胞胎)。分娩时的平均孕周为37 0/7周±3 6/7周(范围26 0/7至41 2/7周)。平均出生体重为2646 g±952 g(范围678至4396 g)。剖宫产率为70%。7例妊娠发生早产(<37周),8例妊娠观察到低出生体重(<2500 g)。分娩时未检测到HIV-1血清学转换。100%的母亲和后代产后超过3个月且仍为血清学阴性。对于血清学不一致夫妇,ICSI的IVF-ET似乎是安全有效的。产科结局良好,HIV-1感染风险有限。

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