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卵巢早衰诊断后的生育规划:324名女性的横断面调查

Family building after diagnosis of premature ovarian insufficiency: a cross-sectional survey in 324 women.

作者信息

Cambray Solange, Dubreuil Sophie, Tejedor Isabelle, Dulon Jérôme, Touraine Philippe

机构信息

Pitié Salpêtrière Hospital, Sorbonne Université Médecine, Department of Endocrinology and Reproductive Medicine, 75651 Paris cedex 13, France.

Center for Rare Gynecologial Disorders, Pitié Salpêtrière Hospital, 75651 Paris cedex 13, France.

出版信息

Eur J Endocrinol. 2023 Mar 2;188(3). doi: 10.1093/ejendo/lvad018.

Abstract

OBJECTIVE

The diagnosis of premature ovarian insufficiency (POI) is a traumatic event for many patients that involves poor fertility prognosis. After such diagnosis, spontaneous pregnancies are rare. The alternatives for building a family are oocyte donation, embryo donation, and adoption. However, we have few information on how many women with POI finally built a family after the diagnosis and which alternative they chose.

DESIGN

We performed a cross-sectional, descriptive study.

METHODS

We conducted a survey of all the women who consulted for POI in the department of endocrinology and reproductive medicine at la Pitié Salpêtrière between May 31, 1991, and January 12, 2021. We included patients who continued to be followed up regularly by our department or were contacted by mail or phone between June and September 2021. We excluded patients with Turner syndrome and POI secondary to oncological treatment and patients under 18 at the time of the survey.

RESULTS

985 patients were referred to the department for POI, and 324 patients were finally analyzed. 41% of the women who wanted to build a family had children after the diagnosis: 53.9% by oocyte donation, 1 woman by embryo donation, 5.6% after ovarian stimulation, 13.5% by adoption, and 25.8% who had spontaneous pregnancy after a mean time of 2.5 years. Spontaneous pregnancy rate was 8.6% in the whole cohort.

CONCLUSIONS

Having children after a diagnosis of POI is not uncommon but more often results from oocyte donation. This study will provide enlightened information for newly diagnosed women on the possibilities to build a family after POI diagnosis.

摘要

目的

对许多患者而言,卵巢早衰(POI)的诊断是一个痛苦的事件,且这意味着生育预后不良。诊断出卵巢早衰后,自然受孕的情况很罕见。组建家庭的替代方式包括卵母细胞捐赠、胚胎捐赠和领养。然而,对于有多少卵巢早衰女性在诊断后最终组建了家庭以及她们选择了哪种替代方式,我们掌握的信息很少。

设计

我们进行了一项横断面描述性研究。

方法

我们对1991年5月31日至2021年1月12日期间在拉皮蒂埃-萨尔佩特里埃医院内分泌与生殖医学科咨询过卵巢早衰的所有女性进行了调查。纳入了那些继续在我们科室定期随访的患者,或者在2021年6月至9月期间通过邮件或电话联系到的患者。我们排除了患有特纳综合征以及因肿瘤治疗导致卵巢早衰的患者,以及调查时未满18岁的患者。

结果

985名患者因卵巢早衰被转诊至该科室,最终分析了324名患者。想要组建家庭的女性中,41%在诊断后有了孩子:53.9%通过卵母细胞捐赠,1名女性通过胚胎捐赠,5.6%在卵巢刺激后受孕,13.5%通过领养,25.8%在平均2.5年后自然受孕。整个队列的自然受孕率为8.6%。

结论

诊断出卵巢早衰后生育并非罕见,但更多是通过卵母细胞捐赠实现的。这项研究将为新诊断的女性提供关于卵巢早衰诊断后组建家庭可能性的有益信息。

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