Chung P H, Yeko T R, Mayer J C, Clark B, Welden S W, Maroulis G B
Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, USA.
J Reprod Med. 1997 Feb;42(2):65-70.
To investigate the effects of active and passive cigarette smoking on the outcome of gamete intrafallopian transfer (GIFT).
A retrospective analysis of 98 patients who had laparoscopic GIFT was performed. Data were retrieved concerning age, diagnosis, amount of human menopausal gonadotropins (hMG) used for controlled ovarian hyperstimulation (COH), and number of oocytes retrieved and transferred. A detailed smoking history, if any, of patients and household members was obtained from chart review and an additional telephone survey. Pregnancy rates and outcome in active and passive smokers were compared to those of non-smokers.
No difference was observed among active smokers (n = 19), passive smokers (n = 13) or nonsmokers (n = 66) regarding diagnosis, age percentage of mature oocytes retrieved or number of oocytes transferred during GIFT. However, active, but nor passive, smokers consumed a higher amount of hMG for COH as compared to nonsmokers. More important, pregnancy and live birth rates for active smokers (15.8% and 10.5%, respectively) were significantly lower than those for passive smokers (46.2% and 23.1%) and nonsmokers (45.5% and 33.3%). No difference, however, was noted between the latter two groups.
Our results show that active, but not passive, smoking has a negative impact on GIFT pregnancy rates and outcomes. It is important to counsel patients against cigarette smoking prior to GIFT, but whether smoking cessation will improve the outcome needs further study.
探讨主动吸烟和被动吸烟对配子输卵管内移植(GIFT)结局的影响。
对98例行腹腔镜GIFT的患者进行回顾性分析。收集有关年龄、诊断、用于控制性卵巢过度刺激(COH)的人绝经期促性腺激素(hMG)用量、获取及移植的卵母细胞数量的数据。通过查阅病历及额外的电话调查,获取患者及其家庭成员详细的吸烟史(如有)。比较主动吸烟者、被动吸烟者和非吸烟者的妊娠率及结局。
在GIFT过程中,主动吸烟者(n = 19)、被动吸烟者(n = 13)和非吸烟者(n = 66)在诊断、年龄、获取的成熟卵母细胞百分比或移植的卵母细胞数量方面未观察到差异。然而,与非吸烟者相比,主动吸烟者(而非被动吸烟者)在COH时使用的hMG量更高。更重要的是,主动吸烟者的妊娠率和活产率(分别为15.8%和10.5%)显著低于被动吸烟者(46.2%和23.1%)和非吸烟者(45.5%和33.3%)。然而,后两组之间未观察到差异。
我们的结果表明,主动吸烟而非被动吸烟对GIFT妊娠率和结局有负面影响。在进行GIFT之前,建议患者戒烟很重要,但戒烟是否会改善结局需要进一步研究。