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使用己酮可可碱鉴定无活动精子患者中活精子的卵胞浆内单精子注射周期的产科和新生儿结局

Obstetric and neo-natal outcomes of ICSI cycles using pentoxifylline to identify viable spermatozoa in patients with immotile spermatozoa.

作者信息

Navas Purificación, Paffoni Alessio, Intra Giulia, González-Utor Antonio, Clavero Ana, Gonzalvo Maria Carmen, Díaz Rocío, Peña Rocío, Restelli Liliana, Somigliana Edgardo, Papaleo Enrico, Castilla Jose A, Viganò Paola

机构信息

Unidad Reproducción, UGC Laboratorio Clínico y UGC Obstetricia y Ginecología, CHU Granada, Instituto de Investigación Biosanitaria de Granada (IIBG), Granada, Spain.

Infertility Unit, Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.

出版信息

Reprod Biomed Online. 2017 Apr;34(4):414-421. doi: 10.1016/j.rbmo.2017.01.009. Epub 2017 Jan 24.

Abstract

Pentoxifylline (PF) represents an effective tool in stimulating motility and identifying viable spermatozoa in intracytoplasmic sperm injection (ICSI) patients presenting exclusively with immotile spermatozoa. However, its use is not universally accepted for its possible detrimental effects on oocytes, embryos or newborns. To evaluate whether PF use may affect obstetrical/neo-natal outcomes, 102 patients achieving a clinical pregnancy after a PF-ICSI in four IVF units in Spain and Italy were followed up after delivery. Neo-natal malformations were classified according to the World Health Organization International Classification of Diseases (ICD-10, range Q00-Q99). Malformation rate was compared with data published by other groups regarding children conceived by conventional IVF or ICSI reporting a 5.3% and 4.4% frequency of ICD-10 codes, respectively. Of 134 clinical pregnancies, 122 babies (82 singletons and 40 twins) were registered. Among singletons, the rates of low birthweight (≤2500 g) and preterm birth (<37 weeks) were 6.1% and12%, respectively. Regarding malformation rate per live births, 4/122 (3.3%, 95% confidence interval: 0.9-8.2%) babies with ICD-10 malformations were recorded. This is the first report on neo-natal outcomes deriving from PF-ICSI. Although based on a limited cohort, results do not suggest an increase of adverse outcomes, including malformation rates, following this procedure.

摘要

己酮可可碱(PF)是一种有效的工具,可用于刺激仅表现为精子不动的卵胞浆内单精子注射(ICSI)患者的精子活力并识别有活力的精子。然而,由于其可能对卵母细胞、胚胎或新生儿产生有害影响,其使用尚未得到普遍认可。为了评估使用PF是否会影响产科/新生儿结局,对西班牙和意大利四个体外受精(IVF)单位中102例在PF-ICSI后实现临床妊娠的患者进行了产后随访。根据世界卫生组织国际疾病分类(ICD-10,范围Q00-Q99)对新生儿畸形进行分类。将畸形率与其他研究组公布的关于通过传统IVF或ICSI受孕儿童的数据进行比较,这些研究分别报告ICD-10编码的发生率为5.3%和4.4%。在134例临床妊娠中,登记了122例婴儿(82例单胎和40例双胎)。在单胎中,低出生体重(≤2500 g)和早产(<37周)的发生率分别为6.1%和12%。关于每例活产的畸形率,记录到4/122例(3.3%,95%置信区间:0.9-8.2%)患有ICD-10畸形的婴儿。这是第一份关于PF-ICSI新生儿结局的报告。尽管基于有限的队列,但结果并不表明该程序后不良结局(包括畸形率)会增加。

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