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抗心磷脂抗体对体外受精-胚胎移植结局的影响。

Impact of anticardiolipin antibody on the outcome of in vitro fertilization and embryo transfer.

机构信息

Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

出版信息

Am J Reprod Immunol. 2011 Dec;66(6):504-9. doi: 10.1111/j.1600-0897.2011.01058.x. Epub 2011 Jul 18.

Abstract

PROBLEM

To investigate the impact of anticardiolipin antibody (ACA) on the outcome of in vitro fertilization and embryo transfer (IVF-ET).

METHODS

A total of 76 infertile women positive for anticardiolipin antibody (ACA+ group) and 819 controls negative for anticardiolipin antibody (ACA- group) undergoing IVF-ET in the First Affiliated Hospital, to Sun Yat-Sen University, were retrospectively analyzed. Women were diagnosed as having pure tubal factor infertility.

RESULTS

The proportion of patients with a history of spontaneous abortion in the ACA+ group was significantly higher than that in ACA- group (19.7% versus 8.9%). The IVF rate, pregnancy rate and implantation rate in the ACA+ group were markedly lower than those in the ACA- group (75.5% versus 78.9%, 31.3% versus 48.6% and 16.1% versus 28.1%, respectively). Furthermore, the incidence of pregnancy loss in the ACA+ group was higher than that in the ACA- group (32.0% versus 15.1%).

CONCLUSION

ACA-positive patients had significantly decreased IVF rate, pregnancy rate and implantation rate and high risk of abortion. Therefore, ACA positivity predicts poor outcome of IVF-ET, and pre-treatment to lower ACA level may be clinically beneficial for patients receiving IVF-ET.

摘要

问题

探讨抗心磷脂抗体(ACA)对体外受精-胚胎移植(IVF-ET)结局的影响。

方法

回顾性分析中山大学附属第一医院 76 例抗心磷脂抗体阳性(ACA+组)和 819 例抗心磷脂抗体阴性(ACA-组)接受 IVF-ET 的不孕妇女。患者均诊断为单纯性输卵管因素不孕。

结果

ACA+组有自然流产史的患者比例明显高于 ACA-组(19.7%比 8.9%)。ACA+组的 IVF 率、妊娠率和种植率明显低于 ACA-组(75.5%比 78.9%,31.3%比 48.6%和 16.1%比 28.1%)。此外,ACA+组的流产率高于 ACA-组(32.0%比 15.1%)。

结论

ACA 阳性患者的 IVF 率、妊娠率和种植率明显降低,流产风险较高。因此,ACA 阳性预测 IVF-ET 结局不良,对接受 IVF-ET 的患者进行 ACA 水平降低的预处理可能具有临床益处。

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