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己烯雌酚暴露女性在体外受精和胚胎移植后,其着床及妊娠结局是否会受到影响?

Are implantation and pregnancy outcome impaired in diethylstilbestrol-exposed women after in vitro fertilization and embryo transfer?

作者信息

Karande V C, Lester R G, Muasher S J, Jones D L, Acosta A A, Jones H W

机构信息

Howard and Georgeanna Jones Institute for Reproductive Medicine, Eastern Virginia Medical School, Norfolk.

出版信息

Fertil Steril. 1990 Aug;54(2):287-91. doi: 10.1016/s0015-0282(16)53705-4.

Abstract

Forty-six infertile women with a history of diethylstilbestrol (DES) exposure in utero underwent 149 stimulation attempts for in vitro fertilization (IVF). The mean (+/- SE) number of preovulatory oocytes harvested at retrieval and transferred was 3.9 +/- 3.3 (536/138) and 2.6 +/- 1.4 (328/124). When compared with patients with tubal factor infertility and less than or equal to 4 pre-embryos transferred, the clinical pregnancy rate (15.3% versus 22%) was not statistically different. However, the term/ongoing pregnancy rate was significantly lower in the study group (8% versus 16%). Comparison of the IVF outcome with different uterine anomalies as detected by hysterosalpingogram (n = 29) showed a trend for a worse prognosis in women with constrictions and a combination of T-shape and constrictions. It is concluded that implantation and pregnancy outcome are impaired in DES-exposed women after IVF.

摘要

46名有子宫内己烯雌酚(DES)暴露史的不孕女性接受了149次体外受精(IVF)刺激尝试。取卵时收获并移植的排卵前卵母细胞平均数量(±标准误)为3.9±3.3(536/138)和2.6±1.4(328/124)。与输卵管因素不孕且移植胚胎数小于或等于4个的患者相比,临床妊娠率(15.3%对22%)无统计学差异。然而,研究组的足月/持续妊娠率显著较低(8%对16%)。通过子宫输卵管造影术检测到不同子宫异常的IVF结果比较(n = 29)显示,有狭窄以及T形和狭窄合并情况的女性预后有变差的趋势。得出的结论是,IVF后DES暴露女性的着床和妊娠结局受损。

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