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单角子宫试管婴儿患者的生殖结局

Reproductive outcomes of IVF patients with unicornuate uteri.

作者信息

Ozgur Kemal, Bulut Hasan, Berkkanoglu Murat, Coetzee Kevin

机构信息

Antalya IVF, Halide Edip Cd. No:7, Kanal Mh., Antalya 07080, Turkey.

Antalya IVF, Halide Edip Cd. No:7, Kanal Mh., Antalya 07080, Turkey.

出版信息

Reprod Biomed Online. 2017 Mar;34(3):312-318. doi: 10.1016/j.rbmo.2016.12.013. Epub 2016 Dec 23.

DOI:10.1016/j.rbmo.2016.12.013
PMID:28040414
Abstract

In this retrospective observational study, the pregnancy, perinatal and obstetric outcomes of patients diagnosed with unicornuate uteri were compared with those of patients with normal uteri after undergoing intracytoplasmic sperm injection (ICSI) with fresh and cryopreserved embryo transfer. From a select population of 9676 infertile patients receiving IVF treatment, 75 (0.78%) were diagnosed with unicornuate uteri between January 2009 and December 2015. Fifty of them underwent ICSI treatment, with 90 fresh and cryopreserved embryo transfers. No significant differences were found between the biochemical, clinical and implantation rates of the first treatment cycles of the two groups; the ongoing pregnancy rate was significantly lower (P = 0.042; 34.0 versus 53.0%) in the unicornis group, as the result of a clinically higher clinical pregnancy loss rates (22.0 versus 15.9%). Twenty-three clinical pregnancies resulted from the 50 first treatment cycles in the unicornis group, resulting in 14 live births, one ongoing pregnancy, five miscarriages, one ectopic pregnancy and two terminations. The 14 live births were delivered at 35.9 gestational weeks, with seven preterm (<37 weeks) and four low birth weight deliveries. Patients with unicornuate uteri are at increased risk of miscarriage, preterm delivery, low birth weight delivery and reduced live birth rates.

摘要

在这项回顾性观察研究中,将诊断为单角子宫的患者在接受新鲜和冷冻胚胎移植的卵胞浆内单精子注射(ICSI)后的妊娠、围产期及产科结局与子宫正常的患者进行了比较。在9676例接受体外受精治疗的不孕患者中,2009年1月至2015年12月期间有75例(0.78%)被诊断为单角子宫。其中50例接受了ICSI治疗,进行了90次新鲜和冷冻胚胎移植。两组首次治疗周期的生化妊娠率、临床妊娠率和着床率之间未发现显著差异;单角子宫组的持续妊娠率显著较低(P = 0.042;34.0%对53.0%),这是由于临床妊娠丢失率在临床上较高(22.0%对15.9%)。单角子宫组的50个首次治疗周期中有23例临床妊娠,产生了14例活产、1例持续妊娠、5例流产、1例异位妊娠和2例终止妊娠。14例活产的孕周为35.9周,其中7例早产(<37周),4例低体重儿。单角子宫患者发生流产、早产、低体重儿及活产率降低的风险增加。

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