Lee Hyun-Mi, Lee Hwa Jeong, Yang Kwang Moon, Cha Sun Hwa, Ahn Hyun Kyong, Kim Young Joo
Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea.
Department of Obstetrics and Gynecology, Medi-i Women's Hospital, Seoul, Korea.
Obstet Gynecol Sci. 2017 Nov;60(6):565-570. doi: 10.5468/ogs.2017.60.6.565. Epub 2017 Sep 27.
This study aims to investigate whether there are any notable etiologies for repeated biochemical pregnancy (RBP) and, if so, to compare those etiologies associated with repeated spontaneous abortion in infertile couples who have undergone fertilization (IVF).
Forty-four infertile couples who underwent IVF and experienced RBP were included in this study. RBP was defined as more than 2 early pregnancy losses that occurred before the detection of a gestational sac, with ectopic pregnancies specifically excluded by serial serum beta human chorionic gonadotropin evaluation. Forty-three infertile couples who underwent IVF and experienced recurrent spontaneous abortion (RSA) were included as a control group. Karyotype analysis, anatomic evaluation of uterus, endocrine and immunological evaluation were performed. In addition, the number of pregnant women confirmed by 12 weeks' gestation was compared between groups.
Immunological factors (RSA: 20.9% vs. RBP: 29.5%, =0.361), diminished ovarian reserve (RSA: 10.9% vs. RBP: 17%, =0.552), and parental chromosomal abnormalities (RSA: 18.6% vs. RBP: 9.1%, =0.218) were not different between groups. Additionally, the incidence of uterine factors (RSA: 11.6% vs. RBP: 4.6%, =0.206), unknown cause (RSA: 48.8% vs. RBP: 54.5%, =0.161), and the pregnancy outcome identified until 12 weeks' gestation (RSA: 46.5% vs. RBP: 38.6%, =0.520) did not differ between groups.
In the present study, the causes of RBP after IVF were similar to those of RSA. Accordingly, we suggest that efforts should be made to define the etiology of RBP, particularly for infertile couples, and that possible management strategies should be offered.
本研究旨在调查反复生化妊娠（RBP）是否存在任何显著病因，若存在，则比较这些病因与接受体外受精（IVF）的不孕夫妇反复自然流产的病因。
本研究纳入了44对接受IVF并经历RBP的不孕夫妇。RBP定义为在检测到妊娠囊之前发生2次以上早期妊娠丢失，通过连续血清β-人绒毛膜促性腺激素评估特别排除异位妊娠。43对接受IVF并经历反复自然流产（RSA）的不孕夫妇作为对照组。进行了核型分析、子宫解剖评估、内分泌和免疫学评估。此外，比较了两组中妊娠12周确诊的孕妇数量。
免疫因素（RSA：20.9% 对RBP：29.5%，P = 0.361）、卵巢储备功能减退（RSA：10.9% 对RBP：17%，P = 0.552）和父母染色体异常（RSA：18.6% 对RBP：9.1%，P = 0.218）在两组之间无差异。此外，子宫因素的发生率（RSA：11.6% 对RBP：4.6%，P = 0.206）、不明原因（RSA：48.8% 对RBP：54.5%，P = 0.161）以及妊娠12周时的妊娠结局（RSA：46.5% 对RBP：38.6%，P = 0.520）在两组之间也无差异。
在本研究中，IVF后RBP的病因与RSA相似。因此，我们建议应努力明确RBP的病因，特别是对于不孕夫妇，并应提供可能的管理策略。
