The Reproductive Outcome of Women with Hypogonadotropic Hypogonadism in IVF.
The Reproductive Outcome of Women with Hypogonadotropic Hypogonadism in IVF.
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体外受精中性腺机能减退症女性的生殖结果
DOI：
10.3389/fendo.2022.850126
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发表时间：
2022
影响因子：
5.2
通讯作者：
中科院分区：
文献类型：
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作者：
本研究的目的是评估接受体外受精和胚胎移植（IVF-ET）的促性腺功能减退症（HH）患者的生殖结局。回顾性评价2010 - 2019年北京大学第三医院生殖医学中心行卵母细胞回收术的81例HH患者和112例对照组的生殖结局。HH组促卵泡激素（FSH）、黄体生成素（LH）、雌二醇（E2）、雄烯二酮(A)、催乳素（PRL）基础水平均显著低于对照组。虽然HH患者比对照组患者需要更长的刺激时间和更高的促性腺激素（Gn）剂量，但两组之间的卵母细胞总数、受精卵、两个原核（2PN）胚胎、可移植胚胎、受精率和2PN率是相当的。虽然对照组第一个新鲜周期的活产率（LBR）高于HH组，但差异无统计学意义。然后我们根据病因将HH患者进一步分为两个亚组。先天性HH (CHH) 41例，后天性HH (AHH) 40例，后者包括功能性下丘脑闭经（FHA）和垂体性HH （PHH）。我们的结果显示，两组患者的基本临床特征和体外受精参数无显著差异。在HH组中，共进行了119个卵母细胞回收周期，它们对促排卵反应充分。绝经期人尿促性腺激素（HMG）单独使用90个周期，HMG与重组人促卵泡激素（rFSH）联合使用29个周期。两组间体外受精相关参数无显著差异。第1、2、≥3个周期后的保守累积活产率（clbr）分别为43.21%、58.02%和60.49%，对应的最佳累积活产率分别为43.21%、68.45%和74.19%。HH患者单胎和双胎早产（PTB）率分别为8.33%（3/36）和30.77%（4/13）。IVF-ET是HH患者不孕的有效治疗方法，患者可获得满意的妊娠结局。
The purpose of this study was to evaluate the reproductive outcome of patients with hypogonadotropic hypogonadism (HH) receiving in vitro fertilization and embryo transfer (IVF-ET). The reproductive outcome of 81 HH patients and 112 controls who underwent oocyte retrieval was evaluated retrospectively in the Center for Reproductive Medicine of Peking University Third Hospital from 2010 to 2019. The basic levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), androstenedione (A) and prolactin (PRL) were significantly lower in the HH group than the control group. Although the HH patients required a significantly longer stimulation and higher gonadotropin (Gn) doses than the control patients, the total number of oocytes retrieved, fertilized embryos, two pronuclear (2PN) embryos, transferable embryos, fertilization and 2PN rates were comparable between the two groups. Although the live birth rate (LBR) of the first fresh cycle was higher in the control group than the HH group, there was no statistical significance. Then we further divided HH patients into two subgroups according to the etiology. Forty-one cases were termed as congenital HH (CHH), while the other 40 cases were termed as acquired HH (AHH), the latter includes functional hypothalamic amenorrhea (FHA) and pituitary HH (PHH). Our results showed that there were no significant differences in basic clinical characteristics and IVF parameters between the two groups. In the HH group, a total of 119 oocyte retrieval cycles were carried out and they responded adequately to ovulation induction. Urinary human menopausal gonadotropin (HMG) was used alone in 90 cycles while combination of HMG and recombinant human follicle stimulating hormone (rFSH) in the other 29 cycles. There were no significant differences in IVF-related parameters between the two groups. The conservative cumulative live birth rates (CLBRs) after the first, the second and ≥third cycles were 43.21%, 58.02% and 60.49%, respectively, while the corresponding optimal CLBRs were 43.21%, 68.45% and 74.19%. The preterm birth (PTB) rates of singletons and twin pregnancy in HH patients were 8.33% (3/36) and 30.77% (4/13), respectively. IVF-ET is an effective treatment for HH patients with infertility and patients can get satisfactory pregnancy outcomes.
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DOI：
10.1056/nejmoa0911064
发表时间：
2011-01-20
期刊：
The New England journal of medicine
影响因子：
--
作者：
Caronia LM;Martin C;Welt CK;Sykiotis GP;Quinton R;Thambundit A;Avbelj M;Dhruvakumar S;Plummer L;Hughes VA;Seminara SB;Boepple PA;Sidis Y;Crowley WF Jr;Martin KA;Hall JE;Pitteloud N
通讯作者：
Pitteloud N
影响因子：
6.1
作者：
Jonard, S;Pigny, P;Dewailly, D
通讯作者：
Dewailly, D
影响因子：
5.6
作者：
Oleari R;Massa V;Cariboni A;Lettieri A
通讯作者：
Lettieri A
影响因子：
158.5
作者：
Malizia, Beth A.;Hacker, Michele R.;Penzias, Alan S.
通讯作者：
Penzias, Alan S.
影响因子：
15.9
作者：
Teixeira, Luis;Guimiot, Fabien;Hardelin, Jean-Pierre
通讯作者：
Hardelin, Jean-Pierre