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在激素替代子宫内膜准备下,通过冻融胚胎移植,17α羟化酶缺乏症女性连续两次成功活产。

Two consecutive successful live birth in woman with 17α hydroxylase deficiency by frozen-thaw embryo transfer under hormone replacement endometrium preparation.

作者信息

Kitajima Michio, Miura Kiyonori, Inoue Tsuneo, Murakami Yuko, Kitajima Yuriko, Murakami Naoko, Taniguchi Ken, Yoshiura Ko-Ichiro, Masuzaki Hideaki

机构信息

a Department of Obstetrics and Gynecology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.

b Department of Human Genetics , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.

出版信息

Gynecol Endocrinol. 2018 May;34(5):381-384. doi: 10.1080/09513590.2017.1393512. Epub 2017 Oct 25.

Abstract

17α-Hydroxylase deficiency is rare autosomal recessive disorder that manifested by hypertension, hypokalemia, delayed sexual development, primary amenorrhea and infertility. The information regarding infertility care and conception in women with this disorder are extremely limited. We report a 24-year-old Japanese woman with primary amenorrhea who was diagnosed as partial 17α-hydroxylase deficiency caused by homozygous 3 bp deletion in exon 1 of 17α-hydroxylase gene. In vitro fertilization with controlled ovarian stimulation was carried out and all viable embryo were frozen. During ovarian stimulation, serum progesterone levels were markedly elevated, and endometrial growth was impaired. Utilizing frozen-thaw embryo transfer under hormonal replacement (glucocorticoid, estradiol and progesterone), she had successfully given two consecutive live birth. Women with 17α-hydroxylase deficiency with residual ovarian reserve can afford reproductive success by appropriate diagnosis and treatment by assisted reproductive technology.

摘要

17α-羟化酶缺乏症是一种罕见的常染色体隐性疾病,表现为高血压、低钾血症、性发育延迟、原发性闭经和不孕。关于患有这种疾病的女性的不孕治疗和受孕的信息极其有限。我们报告一名24岁的日本原发性闭经女性,她被诊断为因17α-羟化酶基因外显子1中纯合3bp缺失导致的部分17α-羟化酶缺乏症。进行了控制性卵巢刺激下的体外受精,并将所有存活胚胎冷冻。在卵巢刺激期间,血清孕酮水平显著升高,子宫内膜生长受损。在激素替代(糖皮质激素、雌二醇和孕酮)下利用冻融胚胎移植,她成功地连续两次活产。有残余卵巢储备的17α-羟化酶缺乏症女性通过辅助生殖技术的适当诊断和治疗能够获得生育成功。

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