摘要
目的 研究在控制性超排卵 (COH)使用促性腺激素释放激素激动剂 (GnRH -a)的过程中发现妊娠的原因及妊娠结局。方法 回顾性分析 1993年 2月至 2 0 0 1年 11月体外受精或卵母细胞浆内单精子显微注射受精与胚胎移植 (IVF/ICSI -ET)超排卵周期使用GnRH -a过程中发现妊娠的临床资料。结果 在 5 180个IVF/ICSI -ET超排卵周期使用GnRH -a的过程中发现妊娠 2 6例 ,发生率为 0 5 0 % ,其中在输卵管因素、男方因素、子宫内膜异位症、盆腔粘连和不明原因各种不孕中的发生率分别为 0 33%、0 37%、2 30 %、0 97%和0 6 4 %。 2 6例妊娠中宫内妊娠 2 0例 ,其中 15例分娩 17个健康新生儿 ,1例正在妊娠 ,流产 2例 ,失访 2例 ;异位妊娠 6例 ,发生率为 2 3 0 8% (6 / 2 6 ) ,输卵管因素中异位妊娠发生率最高达 5 5 5 6 % (5 / 9)。结论 在超排卵周期使用GnRH -a的过程中应注意发生妊娠的可能。宫内妊娠给予安胎治疗 ,可分娩正常新生儿 ;此种妊娠在子宫内膜异位症患者中发生率较高 ,而异位妊娠发生率则在输卵管因素中最高 。
Objective To evaluate the occurrence and outcomes of early human pregnancies exposed to gonadotropin-releasing hormone agonist (GnRH agonist).Methods The clinical data of the pregnancies(from February 1993 to November 2001)exposed to GnRH-a in in vitro fertilization or intracytoplasma sperm injection and embryo transfer(IVF/ICSI-ET) cycles was retrospectively analyzed.Results 26 cases of pregnancies were found to be exposed to GnRH agonist during their controlled ovarian hyperstimulations in 5180 IVF/ICSI-ET cycles,the incidence being 0 50%.The incidence in patients with fallopian tube factor,male factor,endometriosis,pelvic adhesion and other unknown causes were 0 33%,0 37%,2 30%,0 97% and 0 64%,respectively.Among these 26 pregnancies 20 were intrauterine gestation (15 produced 17 normal babies,2 aborted,1 is ongoing pregnancy and 2 could not be followed up).The rest 6 cases were ectopic pregnancy with a rate of 23 08%(6/26).The incidence of ectopic pregnancy in the infertile patients with fallopian tube factor was 55 56%(5/9).Conclusion There appears no increased risk of birth defects or pregnancy wastage in the pregnancies unexpectedly exposed to daily low dose GnRH-a therapy in their very early stage of gestation.Ectopic pregnancy was more common in fallopian tube factor patients.Pregnancy should be carefully monitored to exclude ectopic pregnancy.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2003年第6期353-355,共3页
Chinese Journal of Practical Gynecology and Obstetrics
