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体外受精和胚胎移植后垂体柄中断综合征女性成功妊娠和分娩:病例报告及文献复习。

Successful pregnancy and delivery in a female with pituitary stalk interruption syndrome following in vitro fertilization and embryo transfer: A case report and literature review.

机构信息

Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China.

出版信息

Int J Gynaecol Obstet. 2024 Jun;165(3):870-876. doi: 10.1002/ijgo.15177. Epub 2023 Oct 10.

Abstract

Pituitary stalk interruption syndrome (PSIS) in female patients is mainly characterized by short stature, primary amenorrhea, absent or incomplete sexual maturation, and infertility. Successful pregnancies among these patients are rare. In this report, we describe a successful pregnancy and delivery in a 28-year-old Chinese woman with PSIS following in vitro fertilization and embryo transfer. The patient exhibited typical symptoms, including multiple pituitary hormone deficiency, typical triad signs in magnetic resonance imaging (MRI), undetectable serum gonadotropins and estradiol levels, and invisible antral follicles in both ovaries. During the first attempted controlled ovarian hyperstimulation cycle, 14 oocytes were retrieved and six embryos were acquired. Artificial endometrial preparation and frozen-thawed embryo transfer were performed, resulting in a clinical pregnancy after the transfer of a day 5 blastocyst. The patient was closely monitored throughout the pregnancy and multiple hormone dosages were modulated accordingly. She delivered a healthy boy by elective cesarean section, and the newborn developed normally during a 1-year follow-up period. This is the first report of a successful live birth in a woman with PSIS achieved through in vitro fertilization and frozen-thawed embryo transfer. A literature review on this topic is also presented.

摘要

垂体柄中断综合征(PSIS)在女性患者中主要表现为身材矮小、原发性闭经、性发育不全或缺失以及不孕。这些患者成功妊娠的情况较为罕见。本报告描述了一位 28 岁中国女性 PSIS 患者通过体外受精和胚胎移植成功妊娠和分娩的病例。该患者表现出典型的症状,包括多种垂体激素缺乏、磁共振成像(MRI)中典型三联征、血清促性腺激素和雌二醇水平检测不到、双侧卵巢内未见窦卵泡。在首次尝试控制性卵巢过度刺激周期中,共获得 14 个卵母细胞和 6 个胚胎。进行了人工子宫内膜准备和冻融胚胎移植,在移植第 5 天的囊胚后获得临床妊娠。在整个妊娠期间对患者进行了密切监测,并相应地调整了多种激素剂量。患者通过择期剖宫产娩出一名健康男婴,新生儿在 1 年随访期间发育正常。这是首例通过体外受精和冻融胚胎移植成功分娩 PSIS 患者的报道。本文还对该主题的文献进行了回顾。

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