Chen Xinxia, Liu Peihao, Sheng Yan, Li Weiping, Tang Rong, Ding Lingling, Qin Yingying, Chen Zi-Jiang
a Center for Reproductive Medicine, Shandong University Shandong Provincial Hospital , Jinan , China.
b National Research Center for Assisted Reproductive Technology and Reproductive Genetics , Jinan , China.
J Matern Fetal Neonatal Med. 2019 Aug;32(15):2469-2474. doi: 10.1080/14767058.2018.1438403. Epub 2018 Apr 12.
To evaluate the impact of unicornuate uterus on perinatal outcomes after in vitro fertilization and/or intracytoplasmic sperm injection (IVF/ICSI) cycles.
We performed a retrospective cohort study including 160 women with unicornuate uterus and 1:1 matched controls with normally shaped uterus. They received IVF/ICSI treatment during January 2009 and December 2011. The perinatal outcomes were followed up till December 2014.
There were no significant differences in pregnancy rate, clinical pregnancy rate or live birth rate (53.6 versus 52.7, 41.4 versus 43.5, 33.8% versus 31.8%) between unicornuate uterus group and controls. Their biochemical pregnancy rate (22.8 versus 17.5%) and miscarriage rate (16.0 versus 18.8%) were similar. No significant differences were identified in preterm birth rate (18.3 versus 11.8%), birthweight (3.24 ± 0.60 versus 3.33 ± 0.54 kg) or birth length (50.47 ± 2.33 versus 50.06 ± 2.40 cm) among the singletons. However, lower gestational age (35.56 ± 2.68 versus 36.71 ± 1.73, p = .019), higher preterm birth rate (55.0 versus 34.4%, p = .038), lower birthweight (2.33 ± 0.58 versus 2.69 ± 0.38 kg, p = .001), lower birth length (45.33 ± 2.46 versus 48.88 ± 2.06 cm, p = .000), as well as higher rate of very low birthweight (13.2% versus 0, p = .007) were found for the twins from unicornuate uterus group.
The results indicated unimpaired pregnancy and perinatal outcomes for women with unicornuate uterus conceiving one fetus. However, close attention should be paid to twin pregnancy in unicornuate uterus owing to increased risks of prematurity and low birthweight. Selected single embryo transfer is recommended for women with unicornuate uterus undergoing IVF/ICSI cycles.
评估单角子宫对体外受精和/或卵胞浆内单精子注射（IVF/ICSI）周期后围产期结局的影响。
我们进行了一项回顾性队列研究，纳入160名单角子宫女性和1:1匹配的子宫形态正常的对照者。她们在2009年1月至2011年12月期间接受了IVF/ICSI治疗。围产期结局随访至2014年12月。
单角子宫组与对照组在妊娠率、临床妊娠率或活产率（53.6对52.7、41.4对43.5、33.8%对31.8%）方面无显著差异。其生化妊娠率（22.8对17.5%）和流产率（16.0对18.8%）相似。单胎妊娠的早产率（18.3对11.8%）、出生体重（3.24±0.60对3.33±0.54kg）或出生身长（50.47±2.33对50.06±2.40cm）无显著差异。然而，单角子宫组双胎妊娠的孕周较低（35.56±2.68对36.71±1.73，p = 0.019）、早产率较高（55.0对34.4%，p = 0.038）、出生体重较低（2.33±0.58对2.69±0.38kg，p = 0.001）、出生身长较低（45.33±2.46对48.88±2.06cm，p = 0.000），以及极低出生体重发生率较高（13.2%对0，p = 0.007）。
结果表明，单角子宫女性单胎妊娠时妊娠及围产期结局未受影响。然而，由于早产和低出生体重风险增加，单角子宫女性双胎妊娠应密切关注。建议单角子宫女性在接受IVF/ICSI周期时选择单胚胎移植。
