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接受伴侣供卵与自体受精/卵胞浆内单精子注射的 lesbian 夫妇的生殖结局。

Reproductive Outcomes in Lesbian Couples Undergoing Reception of Oocytes from Partner Versus Autologous Fertilization/Intracytoplasmic Sperm Injection.

机构信息

Clínica Eugin, Research Department, Barcelona, Spain.

Physiology Unit, Department of Physiological Sciences, Faculty of Medicine and Health Sciences, Universitat de Barcelona - UB, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.

出版信息

LGBT Health. 2021 Jul;8(5):367-371. doi: 10.1089/lgbt.2020.0282. Epub 2021 May 31.

Abstract

This study aimed to compare reproductive outcomes after Reception of Oocytes from Partner (ROPA; also called reciprocal fertilization) with those after fertilization/intracytoplasmic sperm injection (IVF/ICSI) with autologous oocytes, in lesbian couples. This was a retrospective matched cohort study of couples performing a first cycle of either ROPA ( = 60) or autologous IVF/ICSI ( = 120) between February 2012 and May 2018. Couples were matched 1:2 by age of the oocyte provider, day of embryo transfer (ET), and number of embryos transferred. Pregnancy and live birth rates after the first ET and cumulative results after all subsequent ETs performed until June 2019 were evaluated. Reproductive outcomes were significantly better after ROPA at first ET: biochemical pregnancy 70.0% versus 47.5% ( = 0.004), clinical pregnancy 60.0% versus 40.0% ( = 0.011), ongoing pregnancy 60.0% versus 36.7% ( = 0.003), and live birth 57.1% versus 29.8% ( = 0.001). After adjusting for age, body mass index, and number of mature oocytes, we still observed a significant improvement across all outcomes in ROPA (live birth rate odds ratio [OR]: 3.05, 95% confidence interval [CI] 1.42-6.57). Cumulative pregnancy and live birth rates were also higher after ROPA (live birth 66.1% vs. 43.4% [ = 0.005]). The adjusted analysis result for cumulative live birth was OR: 2.51, 95% CI: 1.14-5.54. When medically indicated, ROPA can potentially improve reproductive outcomes for lesbian couples through the possibility of selecting the best combination between two oocyte providers and two gestational mothers, provided that both women wish to participate in the pregnancy plan.

摘要

本研究旨在比较接受来自伴侣的卵子(ROPA;也称为互惠受精)和使用自体卵子进行受精/胞浆内精子注射(IVF/ICSI)后的生殖结局,研究对象为女同性恋伴侣。这是一项回顾性匹配队列研究,纳入了 2012 年 2 月至 2018 年 5 月期间进行首次 ROPA(n=60)或自体 IVF/ICSI(n=120)周期的夫妇。根据供卵者的年龄、胚胎移植日(ET)和移植胚胎数,对夫妇进行 1:2 匹配。评估首次 ET 后的妊娠和活产率以及截至 2019 年 6 月所有后续 ET 的累积结果。首次 ET 后 ROPA 的生殖结局明显更好:生化妊娠率 70.0% vs. 47.5%(P=0.004),临床妊娠率 60.0% vs. 40.0%(P=0.011),持续妊娠率 60.0% vs. 36.7%(P=0.003),活产率 57.1% vs. 29.8%(P=0.001)。在校正年龄、体重指数和成熟卵子数后,我们仍观察到 ROPA 对所有结局均有显著改善(活产率比值比[OR]:3.05,95%置信区间[CI]:1.42-6.57)。ROPA 后的累积妊娠和活产率也更高(活产率 66.1% vs. 43.4%[P=0.005])。累积活产的校正分析结果为 OR:2.51,95%CI:1.14-5.54。在医学上有指征的情况下,ROPA 可以通过选择两个供卵者和两个妊娠母亲之间的最佳组合,为女同性恋伴侣提供潜在的改善生殖结局的机会,前提是两个女性都希望参与妊娠计划。

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