J Hepatology:慢性肝病和肝移植患者体外受精的安全性和有效性分析

2021-05-24 MedSci原创 MedSci原创

自1980年代首次试管婴儿怀孕以来,试管婴儿和其他受孕方法方法变得越来越流行。此外,妊娠妇女的肝脏疾病的患病率也逐渐上升。

       自1980年代首次试管婴儿怀孕以来,试管婴儿和其他受孕方法方法变得越来越流行。此外,妊娠妇女的肝脏疾病的患病率也逐渐上升。随着对IVF的认识和可用性的提高,其使用的安全性已成为越来越重要的问题。慢性肝病和肝移植(LT)的后可能会导致女性不孕,30-50%的女性患者会出现闭经,迄今为止,慢性肝病,肝硬化或LT后患者的IVF结局数据很少。本项研究旨在对慢性肝病和肝移植女性患者体外受精的安全性和有效性进行分析。

 

      研究人员纳入的研究对象是1990年至2019年间接受IVF治疗的42例具有IVF肝相关性不育症(LRSF)的女性。结果显示42名患有LRSF的妇女均接受了IVF;6例有肝硬化的妇女进行9个周期的体外受孕,LT后11例妇女进行14个周期的体外受孕,而25例无肝硬化的妇女进行34个周期的体外受孕。肝病的主要病因包括乙肝(HBV),丙肝(HCV)和自身免疫性肝炎(AIH),所有患者中有75%的患者成功植入受精卵。8例(LT后2例,肝硬化3例,无肝硬化4例)患者出现流产。活产率(LBR)为74%(32/43)。9名(22%)肝硬化患者中有2名,LT后有4名(29%)患者IVF尝试均未成功,所有患者中有9个名患者在治疗期间出现肝酶异常,但在治疗完成后改善。6名成功怀孕的患者(LT后患者中有2例,4例无肝硬化)并发产科胆汁淤积症(OC)。卵巢过度刺激综合征(OHSS)很少见(n = 3,7%)。一名接受AIH相关性肝硬化的患者在开始试管受精后出现肝脏失代偿,因此必须停止治疗。

 

 

      患有肝病的妇女或进行过肝移植的妇女怀孕时会遇到困难。但在某些情况下,LRSF女性的IVF可能是成功的,临床医生应就可能增加的OHSS,OC和早产的风险具有清晰的认识。

 

 

原始出处:

Mussarat N. Rahim. Et al. Safety and efficacy of in vitro fertilisation in patients with chronic liver disease and liver transplantation recipients. J Hepatology.2021.

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    2021-06-08 ms4000001114161496

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    2021-05-26 gwc384
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    2021-05-24 124d470dm72暂无昵称

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