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Salpingectomy may decrease antral follicle count but not live birth rate for IVF-ET patients aged 35-39 years: a retrospective study.输卵管切除术可能会降低 35-39 岁 IVF-ET 患者的窦卵泡计数，但不会降低活产率：一项回顾性研究。
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Ectopic pregnancy secondary to in vitro fertilisation-embryo transfer: pathogenic mechanisms and management strategies.体外受精-胚胎移植后继发的异位妊娠：发病机制与管理策略
Reprod Biol Endocrinol. 2015 Apr 12;13:30. doi: 10.1186/s12958-015-0025-0.
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Methotrexate for assisted reproductive technology (ART) ectopic pregnancy.甲氨蝶呤用于辅助生殖技术（ART）相关的异位妊娠
Fertil Steril. 2014 Feb;101(2):e11. doi: 10.1016/j.fertnstert.2013.11.124.

本文引用的文献

1
Effect of single-dose methotrexate on ovarian reserve in women with ectopic pregnancy.单次甲氨蝶呤给药对异位妊娠妇女卵巢储备功能的影响。
Fertil Steril. 2013 Nov;100(5):1310-3. doi: 10.1016/j.fertnstert.2013.06.040. Epub 2013 Jul 24.
2
Effects of treatment of ectopic pregnancy with methotrexate or salpingectomy in the subsequent IVF cycle.异位妊娠治疗中氨甲蝶呤与输卵管切除术对后续 IVF 周期的影响。
Reprod Biomed Online. 2013 May;26(5):449-53. doi: 10.1016/j.rbmo.2013.01.018. Epub 2013 Feb 9.
3
Fertility after ectopic pregnancy: the DEMETER randomized trial.宫外孕后生育能力：DEMETER 随机试验。
Hum Reprod. 2013 May;28(5):1247-53. doi: 10.1093/humrep/det037. Epub 2013 Mar 12.
4
The role of anti-Müllerian hormone in female fertility and infertility - an overview.抗苗勒管激素在女性生育和不孕中的作用——概述。
Acta Obstet Gynecol Scand. 2012 Nov;91(11):1252-60. doi: 10.1111/j.1600-0412.2012.01471.x.
5
Diagnosis of ectopic pregnancy.异位妊娠的诊断。
Clin Obstet Gynecol. 2012 Jun;55(2):387-94. doi: 10.1097/GRF.0b013e31824e3618.
6
Ovarian stimulation affects the levels of regulatory endometrial NK cells and angiogenic cytokine VEGF.卵巢刺激会影响调节性子宫内膜自然杀伤细胞和血管生成细胞因子 VEGF 的水平。
Am J Reprod Immunol. 2011 Feb;65(2):146-53. doi: 10.1111/j.1600-0897.2010.00892.x.
7
Does controlled ovarian stimulation prior to chemotherapy increase primordial follicle loss and diminish ovarian reserve? An animal study.化疗前进行控制性卵巢刺激会增加原始卵泡丢失并减少卵巢储备吗？一项动物研究。
Hum Reprod. 2009 Jan;24(1):206-10. doi: 10.1093/humrep/den337. Epub 2008 Oct 14.
8
Effect of methotrexate exposure on subsequent fertility in women undergoing controlled ovarian stimulation.甲氨蝶呤暴露对接受控制性卵巢刺激的女性后续生育能力的影响。
Fertil Steril. 2009 Aug;92(2):515-9. doi: 10.1016/j.fertnstert.2008.07.009. Epub 2008 Oct 1.
9
Regulation of vascular endothelial growth factor-A and its soluble receptor sFlt-1 by luteinizing hormone in vivo: implication for ovarian follicle angiogenesis.黄体生成素对血管内皮生长因子 -A及其可溶性受体sFlt-1的体内调节：对卵巢卵泡血管生成的影响
Fertil Steril. 2008 Apr;89(4):922-6. doi: 10.1016/j.fertnstert.2007.03.097. Epub 2008 Mar 17.
10
Systemic methotrexate to treat ectopic pregnancy does not affect ovarian reserve.全身应用甲氨蝶呤治疗异位妊娠不影响卵巢储备功能。
Fertil Steril. 2008 Nov;90(5):1579-82. doi: 10.1016/j.fertnstert.2007.08.032. Epub 2007 Dec 11.

异位妊娠或不明部位妊娠行甲氨蝶呤治疗后对卵巢储备功能及随后辅助生殖结局的影响。

Ovarian reserve and subsequent assisted reproduction outcomes after methotrexate therapy for ectopic pregnancy or pregnancy of unknown location.

机构信息

Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.

Washington Hospital Center, Washington, District of Columbia.

出版信息

Fertil Steril. 2014 Feb;101(2):413-9. doi: 10.1016/j.fertnstert.2013.10.027. Epub 2013 Nov 20.

DOI:10.1016/j.fertnstert.2013.10.027
PMID:24269042
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3946660/
Abstract

OBJECTIVE

To assess ovarian reserve after methotrexate treatment for ectopic pregnancy or pregnancy of unknown location after assisted reproductive technology (ART).

DESIGN

Retrospective cohort study.

SETTING

Large ART practice.

PATIENT(S): Women receiving methotrexate or surgery after ART.

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Follicle-stimulating hormone (FSH), antral follicle count (AFC), and oocyte yield compared between women treated with methotrexate or surgery, with secondary outcomes of clinical pregnancy and live birth.

RESULT(S): There were 153 patients in the methotrexate group and 36 patients in the surgery group. Neither group demonstrated differences in ovarian reserve or oocyte yield in a comparison of the before and after treatment values. The change in ovarian reserve and oocyte yield after treatment were similar between the two groups. The number of doses of methotrexate was not correlated with changes in ovarian reserve, indicating no dose-dependent effect. Time between treatment and repeat ART was not correlated with outcomes. Live birth in subsequent cycles was similar in the two groups.

CONCLUSION(S): Ovarian reserve and subsequent ART cycle outcomes were reassuring after methotrexate or surgical management of ectopic pregnancy. No adverse impact of methotrexate was detected in this large fertility cohort as has been previously described elsewhere.

摘要

目的

评估异位妊娠或辅助生殖技术（ART）后不明位置妊娠接受甲氨蝶呤治疗后对卵巢储备的影响。

设计

回顾性队列研究。

地点

大型 ART 实践。

患者

接受甲氨蝶呤或手术治疗的接受 ART 的女性。

干预

无。

主要观察指标

与接受手术治疗的女性相比，接受甲氨蝶呤治疗的女性的卵泡刺激素（FSH）、窦卵泡计数（AFC）和卵母细胞产量，次要结局为临床妊娠和活产。

结果

甲氨蝶呤组有 153 例患者，手术组有 36 例患者。两组在治疗前后的卵巢储备或卵母细胞产量比较中均无差异。两组治疗后卵巢储备和卵母细胞产量的变化相似。甲氨蝶呤的剂量与卵巢储备的变化无关，表明没有剂量依赖性效应。治疗与重复 ART 之间的时间与结果无关。两组后续周期的活产率相似。

结论

异位妊娠接受甲氨蝶呤或手术治疗后，卵巢储备和随后的 ART 周期结局令人安心。在这个大型生育队列中，未发现甲氨蝶呤如先前在其他地方所描述的那样产生不良影响。