Department of Obstetrics and Gynecology, The First Affiliated Hospital of the Air Force Medical University (Xijing Hospital), Xi'an, People's Republic of China.
Department of Obstetrics and Gynecology, The First Affiliated Hospital of the Air Force Medical University (Xijing Hospital), Xi'an, People's Republic of China.
Fertil Steril. 2020 Nov;114(5):1108-1115. doi: 10.1016/j.fertnstert.2020.06.007. Epub 2020 Oct 6.
To present the first live birth after uterine transplantation (UTx) in the People's Republic of China.
Case study.
University hospital.
PATIENT(S): A 22-year-old woman with Mayer-Rokitansky-Kuster-Hauser syndrome and previous surgery for vaginal reconstruction and UTx.
INTERVENTION(S): Endometrial preparation, frozen embryo transfer, pregnancy follow-up, and cesarean section.
MAIN OUTCOME MEASURE(S): Results of in vitro fertilization, frozen embryo transfer, ultrasound measurements during pregnancy, rejection diagnosis and treatment, delivery, live birth, and histology of uterus.
RESULTS(S): Frozen embryo (cleavage stage) transfer started 1.5 years after UTx. The first embryo transfer (n = 2) resulted in a biochemical pregnancy. The second, third, and fourth embryo transfer (n = 2, 2, 3) did not result in pregnancy. The fifth embryo transfer (n = 3) resulted in pregnancy with two gestational sacs, but with spontaneous disappearance of one in early pregnancy. During early pregnancy three episodes of vaginal bleedings occurred (gestational weeks 6 + 2, 13 + 1, and 16 + 3), with a spontaneously resorbing subchorionic hematoma diagnosed at the last bleeding episode. Bleeding episodes were treated with corticosteroids and tacrolimus. During pregnancy, blood flow velocity waveforms and fetal growth parameters were normal. A subacute cesarean section was performed at gestational week 33 + 6 due to uterine contraction pattern suggesting imminent labor. A healthy boy (2,000 g) with Apgar scores of 10, 10, 10 was delivered. The uterus was kept for a possible second pregnancy.
CONCLUSION(S): The first live birth after UTx in the People's Republic of China is reported and this occurred after a robotic-assisted laparoscopic uterus retrieval from the mother.
报道首例在中国进行的子宫移植（UTx）后活产。
病例研究。
大学医院。
一名 22 岁的女性，患有 Mayer-Rokitansky-Kuster-Hauser 综合征，曾行阴道重建和 UTx 手术。
子宫内膜准备、冷冻胚胎移植、妊娠随访、剖宫产。
体外受精、冷冻胚胎移植、妊娠期间超声测量、排斥诊断和治疗、分娩、活产以及子宫组织学结果。
UTx 后 1.5 年开始进行冷冻胚胎（卵裂期）移植。第一次胚胎移植（n=2）导致生化妊娠。第二次、第三次和第四次胚胎移植（n=2、2、3）均未妊娠。第五次胚胎移植（n=3）导致妊娠，有两个孕囊，但在早期妊娠中一个自然消失。早期妊娠期间发生了三次阴道出血（妊娠周数 6+2、13+1 和 16+3），最后一次出血时诊断为自发性绒毛膜下血肿。出血事件用皮质类固醇和他克莫司治疗。妊娠期间，血流速度波形和胎儿生长参数正常。由于宫缩模式提示即将分娩，于妊娠 33+6 周行择期剖宫产。分娩出一名健康男婴（2000g），Apgar 评分为 10、10、10。保留子宫以备可能的再次妊娠。
报道了首例在中国进行的 UTx 后活产，这是在从母亲体内机器人辅助腹腔镜子宫取出后发生的。
