Garrido-Marín Marta, Argacha Pedro Maria, Fernández Luís, Molfino Florencia, Martínez-Soler Fina, Tortosa Avelina, Gimenez-Bonafé Pepita
Department of Physiological Sciences, Physiology Unit, Faculty of Medicine and Health Sciences, Bellvitge Campus, Universitat de Barcelona, IDIBELL, L'Hospitalet del Llobregat, Barcelona 08907, Spain.
Hospital Universitari General de Catalunya, Barcelona 08190, Spain.
World J Clin Cases. 2019 Jan 6;7(1):58-68. doi: 10.12998/wjcc.v7.i1.58.
A 43-year-old woman with an associated history of gynecological pathology and breast cancer with only one cryopreserved embryo wished to be a mother. Several factors that influenced the success of the pregnancy in this case were analyzed. Favorable factors included: triple positive breast cancer [positive hormone receptors and positive human epidermal growth factor receptor 2], which is more hormosensitive and chemosensitive; absence of metastasis; correct endometrium preparation; and the patient's optimistic attitude and strict health habits. In contrast, the factors against success were: breast cancer; adjuvant breast cancer therapy gonadotoxicity; the age of the patient (> 40-year-old); endometriosis; ovarian cyst; hydrosalpinx; submucosal fibroids and the respective associated surgery done for the above-mentioned pathology (all resolved prior to the embryo transfer); and a low quantity of ovules (low ovarian reserve) after ovarian stimulation. This is a very special clinical case of a patient with theoretically low pregnancy success probability due to the consecutive accumulation of gynecological and oncological pathologies, who nonetheless became pregnant and delivered a full-term infant and was able to provide adequate breastfeeding.
一名43岁女性，有妇科疾病史及乳腺癌史，仅冷冻保存了一枚胚胎，希望成为母亲。分析了该病例中影响妊娠成功的几个因素。有利因素包括：三阳性乳腺癌[激素受体阳性和人表皮生长因子受体2阳性]，对激素和化疗更敏感；无转移；子宫内膜准备正确；患者态度乐观且有严格的健康习惯。相反，不利于成功的因素有：乳腺癌；辅助性乳腺癌治疗的性腺毒性；患者年龄（>40岁）；子宫内膜异位症；卵巢囊肿；输卵管积水；黏膜下肌瘤以及针对上述病症进行的相关手术（均在胚胎移植前已解决）；卵巢刺激后卵子数量少（卵巢储备低）。这是一个非常特殊的临床病例，由于妇科和肿瘤疾病的连续累积，理论上妊娠成功概率较低，但该患者仍成功怀孕并足月分娩，且能够进行充分的母乳喂养。
