Center for Reproductive Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Ji Ai Genetics and IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
Reprod Biol Endocrinol. 2024 Aug 6;22(1):97. doi: 10.1186/s12958-024-01272-0.
To examine the reproductive outcomes of assisted reproductive technology (ART) in gynecologic cancer patients and to assess maternal and neonatal complications.
Women diagnosed with gynecologic cancer who underwent their first in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment between 2013 and 2021 at Shanghai Ji Ai Genetics and IVF Institute were included in this study. Infertile women without any history of cancer were matched to the cancer group. The primary outcome was the cumulative live birth rate. Baseline and follow-up data were compared between groups using Student's t-tests for normally distributed variables and with Chi-square test for categorical variables. A propensity score-based patient-matching approach was adopted to ensure comparability between individuals with and without specific cancer type.
A total of 136 patients with a history of gynecologic cancer and 241 healthy infertile controls were included in this study. Endometrial cancer constituted 50.70% of the cases and cervical cancer constituted 34.60% of the cases. The cancer group exhibited significantly shorter duration of stimulation, lower levels of estradiol, lower number of retrieved oocytes, day-3 embryos, and blastocysts compared to the control group (P < 0.05). The cumulative live birth rate of the gynecologic cancer group was significantly lower than that of the control group (36.10% vs. 60.50%, P < 0.001). Maternal and neonatal complications did not significantly differ between the groups (P > 0.05). The endometrial cancer and cervical cancer groups showed significantly lower cumulative live birth rates than their matched controls (38.60% vs. 64.50%, P = 0.011 and 24.20% vs. 68.60%, P < 0.001, respectively).
These findings highlight the decreased occurrence of pregnancy and live birth in female gynecologic cancer patients undergoing ART, particularly in endometrial cancers and cervical cancers. These findings have important implications for counseling and managing gynecologic cancer patients undergoing ART.
探讨妇科癌症患者接受辅助生殖技术（ART）的生殖结局，并评估母婴并发症。
纳入 2013 年至 2021 年在上海集爱遗传与不育诊疗中心首次接受体外受精/卵胞浆内单精子注射（IVF/ICSI）治疗的妇科癌症患者。选择无癌症病史的不孕女性与癌症组进行匹配。主要结局为累积活产率。采用 Student's t 检验比较正态分布变量，采用卡方检验比较分类变量的组间基线和随访数据。采用倾向评分匹配方法确保具有特定癌症类型的个体之间的可比性。
本研究共纳入 136 例妇科癌症病史患者和 241 例健康不孕对照组。子宫内膜癌占 50.70%，宫颈癌占 34.60%。与对照组相比，癌症组的刺激持续时间更短、雌二醇水平更低、获卵数、第 3 天胚胎和囊胚更少（P<0.05）。妇科癌症组的累积活产率明显低于对照组（36.10%比 60.50%，P<0.001）。母婴并发症在两组间无显著差异（P>0.05）。子宫内膜癌和宫颈癌组的累积活产率明显低于其匹配对照组（38.60%比 64.50%，P=0.011 和 24.20%比 68.60%，P<0.001）。
这些发现强调了妇科癌症患者接受 ART 后妊娠和活产率降低，尤其是子宫内膜癌和宫颈癌患者。这些发现对接受 ART 的妇科癌症患者的咨询和管理具有重要意义。
