Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.
Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China.
Front Endocrinol (Lausanne). 2021 Apr 29;12:648287. doi: 10.3389/fendo.2021.648287. eCollection 2021.
Diminished ovarian reserve (DOR) is one of the most intractable clinical issues in human reproduction and is reported to be associated with raised risk of recurrent pregnancy loss and aneuploid blastocysts. In this study, we aimed to explore whether DOR was also associated with maternal and neonatal complications in fertilization/intracytoplasmic sperm injection cycles.
A retrospective cohort study including women below 40 years of age who achieved singleton live birth after fresh embryo transfer in fertilization/intracytoplasmic sperm injection cycles in a single center from January 2012 to June 2019 was conducted. Participants with DOR, defined as basal follicle-stimulating hormone (FSH) ≥ 10IU/L and antimullerian hormone (AMH) < 1.2ng/ml, were enrolled as the study group. The controls were 1:2 matched by age and body mass index with FSH < 10IU/L and AMH ≥ 1.2ng/ml. Maternal and neonatal complications were compared between the DOR group and the controls.
A total of 579 women, 193 in the DOR group and 386 matched as controls, were included in this study. Compared to controls, the incidence of hypertensive disorders of pregnancy was significantly increased in the DOR group (5.7% . 2.1%, = 0.021). DOR patients also presented slightly higher incidences of preterm birth (10.9% . 7.5%, = 0.174) and low birthweight (6.2% . 5.4%, = 0.704) yet without statistical significances. The incidences of gestational diabetes mellitus and placenta previa were comparable between the two groups.
Compared to women with normal ovarian reserve, women with diminished ovarian reserve might have elevated incidence of hypertensive disorders of pregnancy. Patients with diminished ovarian reserve might need more strict antenatal care.
卵巢储备功能降低（DOR）是人类生殖中最棘手的临床问题之一，据报道，它与复发性妊娠丢失和非整倍体囊胚的风险增加有关。在这项研究中，我们旨在探讨 DOR 是否也与体外受精/卵胞浆内单精子注射（IVF/ICSI）周期中的母婴并发症有关。
一项回顾性队列研究，纳入了 2012 年 1 月至 2019 年 6 月在一家中心接受新鲜胚胎移植后获得单胎活产的年龄<40 岁的妇女。DOR 组的定义为基础卵泡刺激素（FSH）≥10IU/L 和抗苗勒管激素（AMH）<1.2ng/ml。将 FSH<10IU/L 和 AMH≥1.2ng/ml 的患者按年龄和体重指数（BMI）1:2 匹配为对照组。比较 DOR 组与对照组之间的母婴并发症。
共纳入 579 名妇女，DOR 组 193 名，对照组 386 名。与对照组相比，DOR 组妊娠高血压疾病的发生率明显升高（5.7% vs. 2.1%， = 0.021）。DOR 患者的早产（10.9% vs. 7.5%， = 0.174）和低出生体重（6.2% vs. 5.4%， = 0.704）的发生率也略高，但无统计学意义。两组妊娠期糖尿病和前置胎盘的发生率无差异。
与卵巢储备正常的妇女相比，卵巢储备功能降低的妇女妊娠高血压疾病的发生率可能升高。卵巢储备功能降低的患者可能需要更严格的产前护理。
