子宫内膜不典型增生或子宫内膜癌患者实施辅助生殖技术后妊娠结局的临床分析

Clinical analysis of fertility outcomes after assisted reproductive technology in patients with atypical hyperplasia or endometrial carcinoma

目的探究辅助生殖技术对子宫内膜不典型增生(AH)或早期子宫内膜癌(EC)患者妊娠结局的影响。方法回顾性分析2011年1月至2017年12月在湘雅医院生殖医学中心行体外受精/卵胞浆内单精子显微注射-胚胎移植(IVF/ICSI-ET)及冻胚移植(FET)的AH或EC患者18例的临床资料。结果 18例患者中,AH 15例,EC 3例,平均年龄(31.78±0.79)岁,不孕年限(6.0±0.96)年,平均体质指数(24.21±0.67)kg/m2,共行IVF/ICSI-ET和FET 38个周期,移植30个周期,每移植周期临床妊娠率为61.5%(16/26),活产率为33.3%(10/30),流产率为20.0%(6/30)。随访至2018年12月,所有患者子宫内膜病变均未复发。结论辅助生殖技术有利于改善AH或EC患者的妊娠结局,为个体化治疗提供了更多选择。

Objective To evaluate fertility outcomes in women with atypical hyperplasia(AH) or endometrial carcinoma(EA) who underwent assisted reproductive technology(ART). Methods 18 patients who diagnosed with either AH or EC received in-vitro fertilization/intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET) or frozen embryo transplantation(FET) in the Reproductive Medical Center of Xiangya Hospital from January 2011 to December 2017 were retrospectively analyzed. Results Among the 18 patients, 15 cases were AH and 3 were EC. The mean age were(37.78±0.79) years, duration of infertility were 6.0±0.96 years;mean body mass index were(24.21±0.67) kg/m^2;A total of 38 cycles of IVF/ICSI-ET and FET were performed, and 30 cycles of transplantation were performed. The clinical pregnancy rate per transfer cycle was 61.5%(16/26);the live birth rate was 33.3%(10/30) and the miscarriage rate was 20.0%(6/30). All patients were followed-up untill December 2018 and no recurrence was found. Conclusion Assisted reproductive technology can effectively improve the likelihood of pregnancy in patients with AH or EC, providing more choices for individual treatment.