Pregnancy Achieved Using Donor Eggs in Cancer Survivors with Treatment-Induced Ovarian Failure: Obstetric and Perinatal Outcome
Pregnancy Achieved Using Donor Eggs in Cancer Survivors with Treatment-Induced Ovarian Failure: Obstetric and Perinatal Outcome
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DOI：
10.1089/jwh.2017.6703
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发表时间：
2018-05-01
影响因子：
3.5
通讯作者：
Rodriguez-Wallberg, Kenny A.
中科院分区：
文献类型：
--
作者：
Marklund, Anna;Nasiell, Josefine;Rodriguez-Wallberg, Kenny A.
背景：捐卵是一种常见的生育治疗女性癌症幸存者与生殖的愿望和医源性卵巢功能衰竭。我们研究了以前接受过癌症治疗的妇女是否有更高的风险怀孕并发症后卵子捐赠治疗时相比，妇女没有cancer history.Methods：在这个前瞻性队列治疗在2003-2015年在一个单一的中心，31名妇女以前的癌症病史实现了25交付和212名妇女没有癌症病史实现了244交付。所有的卵子供体治疗都严格执行单胚胎移植政策，以减少妊娠和围产期并发症。使用logistic回归分析数据，调整相关混杂因素，以估计围产期和产科结局的调整优势比（aOR）和95%置信区间（CI）。结果：有癌症史的妇女发生妊娠并发症的风险显著增加，包括早产（aOR 5.54，95% CI 2.01-15.31）和先兆子痫（aOR 2.79，95%CI 1.07-7.34）。结论：这项研究的结果表明，通过卵子供体治疗怀孕的既往癌症女性的早产和先兆子痫风险显着超过接受类似治疗的无癌症史女性。由于使用供体卵子的妊娠已经被公认为高血压疾病的风险较高，因此本研究提醒对癌症幸存者女性的特定风险增加进行表征，以提供适应性妊娠监测。
Background: Egg donation is a common fertility treatment in female cancer survivors with reproductive wish and iatrogenic ovarian failure. We examined whether women previously treated for cancer have a higher risk of pregnancy complications after egg donation treatments when compared to women without cancer history.Methods: In this prospective cohort treated during 2003-2015 at a single center, 31 women with previous history of cancer achieved 25 deliveries and 212 women without cancer history achieved 244 deliveries. All egg donor treatments were performed with a strict policy of single embryo transfer to reduce pregnancy and perinatal complications. Data were analyzed using logistic regression with adjustment for relevant confounders, to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for perinatal and obstetric outcomes. Women without previous history of cancer were used as the reference group in the regression models.Results: Women with a history of cancer presented with a significantly increased risk of pregnancy complications, including preterm birth (aOR 5.54, 95% CI 2.01-15.31) and preeclampsia (aOR 2.79, 95% CI 1.07-7.34), compared to women without cancer history.Conclusions: The findings of this study suggest that the risks of preterm birth and preeclampsia in women with prior cancers who become pregnant by egg donor treatment significantly exceed those of women without cancer history undergoing similar treatments. As pregnancies using donor eggs are already acknowledged of higher risk for hypertensive pathologies, this study alerts toward characterization of specific increased risks in women who are cancer survivors to provide adapted pregnancy monitoring.