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接受子宫移植的先天性无阴道综合征女性的辅助生殖技术与妊娠结局:捷克的经验

Assisted Reproductive Techniques and Pregnancy Results in Women with Mayer-Rokitansky-Küster-Hauser Syndrome Undergoing Uterus Transplantation: the Czech Experience.

作者信息

Chmel Roman, Cekal Milos, Pastor Zlatko, Chmel Roman, Paulasova Petra, Havlovicova Marketa, Macek Milan, Novackova Marta

机构信息

Department of Obstetrics and Gynaecology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.

Department of Obstetrics and Gynaecology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.

出版信息

J Pediatr Adolesc Gynecol. 2020 Aug;33(4):410-414. doi: 10.1016/j.jpag.2020.03.006. Epub 2020 Mar 26.

Abstract

STUDY OBJECTIVE

This study aimed to evaluate the reproductive potential of patients with Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) who were candidates for uterus transplantation (UTx) before inclusion in the experimental trial, and to summarize the existing experience with posttransplantation embryo transfers in functionally successful cases.

DESIGN AND SETTING

A prospective study at a tertiary medical center.

PARTICIPANTS

Ten pre-UTx women with MRKHS and 7 successful UTx cases.

INTERVENTIONS AND MAIN OUTCOME MEASURES

Ovarian stimulations, frozen embryo collection, embryo transfers, and incidence of pregnancy in MRKHS women in the pre- and posttransplantation periods.

RESULTS

The average number of ovarian stimulations to collect the required frozen embryos was 1.9 (1-3). On average, the number of aspirated oocytes was 16.4 (7-38), 12.6 (5-26) oocytes were fertilized, and 7.0 (1-18) embryos were cryopreserved per cycle. To date, the average number of embryo transfers per recipient was 4.9 (3-8), and the embryo transfer/pregnancy rate was 8.8% (3 of 34). Three pregnancies have been achieved to date, including a missed abortion in the 8th week, a birth in the 35th week, and an ongoing pregnancy in the 30th week.

CONCLUSIONS

Despite the small number of UTx cases, our data indicated that women with MRKHS showed a good response to ovarian stimulation and blastocyst formation. Although the procedures for fertilization, cryopreservation, and transfer of the embryos were standardized, the success rate per embryo transfer achieved in the study group has been low to date.

摘要

研究目的

本研究旨在评估拟纳入子宫移植(UTx)试验的先天性无阴道综合征(MRKHS)患者的生殖潜能,并总结功能成功病例的移植后胚胎移植的现有经验。

设计与地点

在一家三级医疗中心进行的前瞻性研究。

参与者

10名拟进行子宫移植的MRKHS女性患者和7例子宫移植成功的病例。

干预措施及主要观察指标

MRKHS女性患者移植前后的卵巢刺激、冷冻胚胎采集、胚胎移植及妊娠发生率。

结果

采集所需冷冻胚胎的平均卵巢刺激次数为1.9次(1 - 3次)。平均每个周期吸出的卵母细胞数为16.4个(7 - 38个),受精的卵母细胞数为12.6个(5 - 26个),冷冻保存的胚胎数为7.0个(1 - 18个)。迄今为止,每位受者的平均胚胎移植次数为4.9次(3 - 8次),胚胎移植/妊娠率为8.8%(34次移植中有3次妊娠)。迄今为止已实现3次妊娠,包括第8周的稽留流产、第35周的分娩以及第30周的持续妊娠。

结论

尽管子宫移植病例数量较少,但我们的数据表明,MRKHS女性对卵巢刺激和囊胚形成反应良好。虽然胚胎的受精、冷冻保存和移植程序是标准化的,但迄今为止研究组每次胚胎移植的成功率较低。

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