1 Department of Oncology-Pathology, Intervention and Technology - CLINTEC, Karolinska Institutet , Stockholm, Sweden .
3 Department of Obstetrics and Gynecology, Södersjukhuset , Stockholm, Sweden .
J Womens Health (Larchmt). 2018 Jul;27(7):939-945. doi: 10.1089/jwh.2017.6703. Epub 2018 May 1.
Egg donation is a common fertility treatment in female cancer survivors with reproductive wish and iatrogenic ovarian failure. We examined whether women previously treated for cancer have a higher risk of pregnancy complications after egg donation treatments when compared to women without cancer history.
In this prospective cohort treated during 2003-2015 at a single center, 31 women with previous history of cancer achieved 25 deliveries and 212 women without cancer history achieved 244 deliveries. All egg donor treatments were performed with a strict policy of single embryo transfer to reduce pregnancy and perinatal complications. Data were analyzed using logistic regression with adjustment for relevant confounders, to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for perinatal and obstetric outcomes. Women without previous history of cancer were used as the reference group in the regression models.
Women with a history of cancer presented with a significantly increased risk of pregnancy complications, including preterm birth (aOR 5.54, 95% CI 2.01-15.31) and preeclampsia (aOR 2.79, 95% CI 1.07-7.34), compared to women without cancer history.
The findings of this study suggest that the risks of preterm birth and preeclampsia in women with prior cancers who become pregnant by egg donor treatment significantly exceed those of women without cancer history undergoing similar treatments. As pregnancies using donor eggs are already acknowledged of higher risk for hypertensive pathologies, this study alerts toward characterization of specific increased risks in women who are cancer survivors to provide adapted pregnancy monitoring.
对于有生育愿望和医源性卵巢功能衰竭的女性癌症幸存者来说，卵子捐赠是一种常见的生育治疗方法。我们研究了与无癌症史的女性相比，以前接受过癌症治疗的女性在接受卵子捐赠治疗后是否有更高的妊娠并发症风险。
在这项 2003 年至 2015 年期间在单一中心进行的前瞻性队列研究中，31 名有癌症既往史的女性实现了 25 次分娩，212 名无癌症史的女性实现了 244 次分娩。所有的卵子捐赠治疗都采用严格的单胚胎移植政策，以减少妊娠和围产期并发症。使用逻辑回归分析数据，并进行相关混杂因素的调整，以估计围产期和产科结局的调整比值比（aOR）和 95%置信区间（CI）。在回归模型中，无癌症既往史的女性作为参考组。
与无癌症史的女性相比，有癌症既往史的女性妊娠并发症的风险显著增加，包括早产（aOR 5.54，95%CI 2.01-15.31）和子痫前期（aOR 2.79，95%CI 1.07-7.34）。
本研究结果表明，接受卵子捐赠治疗后怀孕的有既往癌症史的女性发生早产和子痫前期的风险明显高于接受类似治疗的无癌症史的女性。由于使用供体卵子的妊娠已经被认为有更高的高血压疾病风险，因此本研究提醒人们关注癌症幸存者的特定风险增加，以便提供适应性的妊娠监测。
