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反复种植失败(RIF)后的妊娠率及妊娠时间——一项前瞻性队列随访研究

Pregnancy rate and time to pregnancy after recurrent implantation failure (RIF)-a prospective cohort follow-up study.

作者信息

Stevens Brentjens Linda B P M, Roumen Relinde J E, Smits Luc, Derhaag Josien, Romano Andrea, van Golde Ron J T, den Hartog Janneke E

机构信息

Department of Obstetrics and Gynaecology, Maastricht University Medical Center+, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands.

GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands.

出版信息

J Assist Reprod Genet. 2024 Nov;41(11):3061-3070. doi: 10.1007/s10815-024-03257-9. Epub 2024 Sep 30.

DOI:10.1007/s10815-024-03257-9
PMID:39349892
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11621263/
Abstract

PURPOSE

The goal of this study was to determine ongoing pregnancy rate, time to pregnancy and embryo transfers to pregnancy within a cohort of patients with recurrent implantation failure (RIF).

METHODS

IVF patients with RIF were included after referral to the RIF outpatient clinic. They received a questionnaire 1 year after inclusion. If data was missing, medical files were examined to determine pregnancy outcomes and conception methods. The ability of the RIF outpatient clinic to improve pregnancy chance or increase the number of patients who elected to continue treatment was beyond the scope of this study.

RESULTS

The cumulative incidence of ongoing pregnancy in IVF patients with RIF (n = 79) after 1 year of follow-up was 40.5% (95% confidence interval = 30.4-51.5%). Median time to pregnancy was 4 months. Pregnancy incidence increased gradually up to 5 embryo transfers (mostly single embryo transfers). The average embryo transfers to pregnancy were 7.3 transfers.

CONCLUSION

In IVF patients with RIF, up until the 5th embryo transfer, each transfer represents a good opportunity for ongoing pregnancy. This data can be used to counsel patients that regular treatment continuation seems to be well justified even when IVF patients fulfil the RIF criteria.

TRIAL REGISTRATION

CCMO: NL66835.068.18. METC 18-040. OMON: NL-OMON24778.

摘要

目的

本研究的目的是确定复发性植入失败(RIF)患者队列中的持续妊娠率、妊娠时间和胚胎移植至妊娠的情况。

方法

转诊至RIF门诊的体外受精(IVF)患者被纳入研究。纳入后1年,他们收到一份问卷。如果数据缺失,则查阅医疗档案以确定妊娠结局和受孕方式。RIF门诊改善妊娠机会或增加选择继续治疗的患者数量的能力超出了本研究的范围。

结果

随访1年后,RIF的IVF患者(n = 79)的持续妊娠累积发生率为40.5%(95%置信区间 = 30.4 - 51.5%)。妊娠的中位时间为4个月。直至5次胚胎移植(大多为单胚胎移植)时,妊娠发生率逐渐增加。妊娠的平均胚胎移植次数为7.3次。

结论

在RIF的IVF患者中,直至第5次胚胎移植,每次移植都是实现持续妊娠的良好机会。该数据可用于向患者提供咨询,即即使IVF患者符合RIF标准,定期继续治疗似乎也很合理。

试验注册

CCMO:NL66835.068.18。METC 18 - 040。OMON:NL - OMON24778。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6984/11621263/67c16c51ab78/10815_2024_3257_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6984/11621263/da2cf5121f0c/10815_2024_3257_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6984/11621263/afec27fab38e/10815_2024_3257_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6984/11621263/67c16c51ab78/10815_2024_3257_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6984/11621263/da2cf5121f0c/10815_2024_3257_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6984/11621263/afec27fab38e/10815_2024_3257_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6984/11621263/67c16c51ab78/10815_2024_3257_Fig3_HTML.jpg

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本文引用的文献

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Front Med (Lausanne). 2024 Apr 16;11:1348733. doi: 10.3389/fmed.2024.1348733. eCollection 2024.
2
Does recurrent implantation failure exist? Prevalence and outcomes of five consecutive euploid blastocyst transfers in 123 987 patients.复发性植入失败是否存在?123987例患者连续五次整倍体囊胚移植的发生率和结局
Hum Reprod. 2024 May 2;39(5):974-980. doi: 10.1093/humrep/deae040.
3
ESHRE good practice recommendations on recurrent implantation failure.
欧洲人类生殖与胚胎学会关于反复种植失败的良好实践建议。
Hum Reprod Open. 2023 Jun 15;2023(3):hoad023. doi: 10.1093/hropen/hoad023. eCollection 2023.
4
Non-Invasive and Mechanism-Based Molecular Assessment of Endometrial Receptivity During the Window of Implantation: Current Concepts and Future Prospective Testing Directions.着床窗口期子宫内膜容受性的非侵入性和基于机制的分子评估:当前概念与未来前瞻性检测方向
Front Reprod Health. 2022 May 4;4:863173. doi: 10.3389/frph.2022.863173. eCollection 2022.
5
Endometrial factors in the implantation failure spectrum: protocol of a MUltidisciplinary observational cohort study in women with Repeated Implantation failure and recurrent Miscarriage (MURIM Study).子宫内膜因素在着床失败谱中的作用:一项针对反复着床失败和复发性流产患者的多学科观察性队列研究方案(MURIM 研究)。
BMJ Open. 2022 Jun 8;12(6):e056714. doi: 10.1136/bmjopen-2021-056714.
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