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不明原因复发性流产和着床失败的脂肪乳剂治疗:病例系列和文献复习。

Intralipid therapy for unexplained recurrent miscarriage and implantation failure: Case-series and literature review.

机构信息

AP-HP, Hôpital Saint Antoine, service de médecine interne et Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Faculté de Médecine Sorbonne Université, F-75012, Paris, France; Sorbonne Universités, UPMC Université Paris 06, UMR 7211, F-75005, Paris, France.

Sorbonne Universités, UPMC Université Paris 06, UMR 7211, F-75005, Paris, France; AP-HP, Hôpital Tenon, service de gynécologie, obstétrique et PMA, Faculté de Médecine Sorbonne Université, F-75020, Paris, France.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2020 Sep;252:100-104. doi: 10.1016/j.ejogrb.2020.06.017. Epub 2020 Jun 16.

DOI:10.1016/j.ejogrb.2020.06.017
PMID:32592916
Abstract

INTRODUCTION

In retrospective cohort study of women with unexplained recurrent implantation failure (RIF) and miscarriage (RM), we analyzed the efficacy and safety of intralipid therapy to obtain a live birth.

PATIENTS AND METHODS

Women with unexplained RM and/or RIF were included from 2015 to 2018 from three French university hospitals.

RESULTS

Among 187 women treated for unexplained recurrent miscarriages and implantation failures, 26 women with median age of 36 years (29-43) received intralipid therapy. Among these 26 women, 10 women with a median age of 33 years (31-40) had a history of spontaneous recurrent miscarriages, with a median of 5 (4-8) previous miscarriages. Live births occurred in 7 (70 %) pregnancies under intralipids and were significantly more frequent than in women with recurrent miscarriages who did not receive intralipid therapy (n = 20, p = 0.02). Age, number of previous miscarriages, and additional therapies did not significantly differ between the two groups. Among the 26 included women, 16 had a history of recurrent implantation failures, with median age of 37 years (29-43) and median 9.5 (3-19) embryo transfers. Clinical pregnancy occurred in 9 (56 %) women receiving intralipids after embryo transfers under intralipids among which 5 (55 %) resulted in a live birth. Comparing successful pregnancies under intralipids with those with fetal loss, no significant differences have been noted.

CONCLUSION

Intralipids could be an effective and safe therapy in women with unexplained recurrent miscarriages and infertility.

摘要

介绍

在一项对不明原因复发性植入失败(RIF)和流产(RM)的女性进行的回顾性队列研究中,我们分析了脂肪乳治疗以获得活产的疗效和安全性。

患者和方法

从 2015 年至 2018 年,我们从三家法国大学医院纳入不明原因 RM 和/或 RIF 的女性。

结果

在 187 名接受不明原因复发性流产和植入失败治疗的女性中,26 名中位年龄为 36 岁(29-43 岁)的女性接受了脂肪乳治疗。在这 26 名女性中,10 名中位年龄为 33 岁(31-40 岁)的女性有自然复发性流产史,有 5 次(4-8 次)流产史。在接受脂肪乳治疗的 7 例(70%)妊娠中发生了活产,显著高于未接受脂肪乳治疗的复发性流产女性(n=20,p=0.02)。两组之间的年龄、既往流产次数和附加治疗无显著差异。在纳入的 26 名女性中,16 名有复发性植入失败史,中位年龄为 37 岁(29-43 岁),中位数 9.5(3-19)次胚胎移植。在接受脂肪乳治疗的胚胎移植中,9 例(56%)女性发生临床妊娠,其中 5 例(55%)活产。将接受脂肪乳治疗的成功妊娠与胎儿丢失进行比较,未发现显著差异。

结论

脂肪乳可能是不明原因复发性流产和不孕女性的一种有效且安全的治疗方法。

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