Division of Obstetrics and Gynecology, Center for Assisted Reproductive Technology, Careggi University Hospital, Florence, Italy.
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
J Womens Health (Larchmt). 2021 May;30(5):758-764. doi: 10.1089/jwh.2020.8383. Epub 2020 Dec 18.
The last two decades have seen a growing number of pregnancies in women who needed the donation of oocytes. With oocyte donation pregnancies, studies on obstetric outcomes among these women revealed an increased incidence of pre-eclampsia and pregnancy-induced hypertension. Furthermore, several studies have found a higher incidence of low birth weight, preterm birth, and delivery by cesarean section in oocyte donation rather than in women subjected to assisted reproduction techniques (ART) with autologous oocytes. Numerous studies have also shown a deep connection between cardiovascular and thrombotic risk factors and adverse pregnancy outcomes. In this setting, to strictly assess the preconceptional risk for women who undergo egg donation to achieve pregnancy, the aim of our study is to draw a detailed assessment of the vascular risk profile of patients with gamete donation ART indications through the evaluation of comorbidities and cardiometabolic and thrombophilic markers Patients undergoing ART with oocyte or sperm donation or double donation of gametes underwent a careful clinical assessment through a detailed personal and family anamnesis and they were evaluated for cardiometabolic and thrombophilic profile. Clinical and demographic characteristics, comorbidities, and biohumoral parameters were collected. The study was approved by the Regional Ethical Committee(Em 2018-017 CINECA 10189). We evaluated 525 women. Around 73.1% were >40 years and 35% of them were older than 45 years. There was a high prevalence of dyslipidemias (58.1%), smoking habit (24.6%), a body mass index >25 in 28.6% of patients, a high abdominal circumference in 58.1% of cases, a prevalence of acquired thrombophilia in about 7% and hereditary of 19.2%. Around 39.2% of patients had total cholesterol >200 mg/dL, 19.5% had high-density lipoprotein <48 mg/dL and 43.6% had low-density lipoprotein >115 mg/dL, and 6.9% had triglyceride values >150 mg/dL. A careful assessment of the preconceptional status of patients undergoing ART programs with oocyte donation can be highly recommended.
在过去的二十年中，越来越多需要捐卵的女性怀孕。对于接受捐卵的女性，研究发现其子痫前期和妊娠高血压的发生率增加。此外，多项研究发现，与接受自体卵子辅助生殖技术 (ART) 的女性相比，捐卵的女性中低出生体重儿、早产和剖宫产的发生率更高。大量研究还表明，心血管和血栓形成危险因素与不良妊娠结局之间存在密切联系。在这种情况下，为了严格评估接受捐卵以实现妊娠的女性的孕前风险，我们的研究旨在通过评估合并症和心脏代谢及血栓形成标志物来详细评估有配子捐赠 ART 适应证的患者的血管风险状况。接受卵或精子捐赠或配子双捐赠的 ART 患者接受了详细的临床评估，包括详细的个人和家族病史，并评估了其心脏代谢和血栓形成特征。收集了临床和人口统计学特征、合并症和生物化学参数。该研究得到了区域伦理委员会的批准（Em 2018-017 CINECA 10189）。
我们评估了 525 名女性。大约 73.1%的患者年龄大于 40 岁，其中 35%的患者年龄大于 45 岁。血脂异常（58.1%）、吸烟习惯（24.6%）、28.6%的患者体重指数大于 25、58.1%的患者腰围大、获得性血栓形成倾向的患病率约为 7%、遗传性血栓形成倾向的患病率为 19.2%。大约 39.2%的患者总胆固醇 >200mg/dL，19.5%高密度脂蛋白 <48mg/dL，43.6%低密度脂蛋白 >115mg/dL，6.9%甘油三酯值 >150mg/dL。强烈建议对接受卵捐赠的 ART 方案患者进行孕前状态的仔细评估。
