The Clinical Outcomes of In Vitro Fertilization/Intracytoplasmic Sperm Injection Treatments in 43 Women with a History of Gestational Trophoblastic Disease
Background: To analyze the clinical outcomes of in vitro fertilization (IVF)/intracytoplasmic sperm injection treatments in women with a history of gestational trophoblastic disease (GTD). Methods: This retrospective study included 43 patients with a history of GTD as the study group and 43 matched...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health/LWW
2018-01-01
|
| Series: | Reproductive and Developmental Medicine |
| Subjects: | |
| Online Access: | http://www.repdevmed.org/article.asp?issn=2096-2924;year=2018;volume=2;issue=1;spage=38;epage=45;aulast=Shen |
| _version_ | 1818246207443566592 |
|---|---|
| author | Xi Shen Yan-Ping Kuang |
| author_facet | Xi Shen Yan-Ping Kuang |
| author_sort | Xi Shen |
| collection | DOAJ |
| description | Background: To analyze the clinical outcomes of in vitro fertilization (IVF)/intracytoplasmic sperm injection treatments in women with a history of gestational trophoblastic disease (GTD).
Methods: This retrospective study included 43 patients with a history of GTD as the study group and 43 matched patients as the control group. The patients in the study group were divided into two groups according to the therapy received. Patients in Subgroup A (n = 32) underwent uterine curettage treatment only. Patients in Subgroup B (n = 11) underwent uterine curettage combined with chemotherapy. The characteristics of ovarian stimulation and outcomes of embryos and pregnancy were compared.
Results: In the first cycle, there was a higher number of retrieved oocytes and normal fertilized oocytes in the control group than those in the study group (9.2 vs. 6.2 and 6.0 vs. 4.0, respectively; P < 0.05); however, a similar mature oocyte rate (83.5% vs. 85.0%), normal fertilization rate (84.5% vs. 80.1%), number of good-quality embryos (1 vs. 2), and viable embryos (2 vs. 2) were found between the two groups (P > 0.05). There was no difference in the outcomes between Subgroup A and Subgroup B. There was a significant difference in thickness of the endometrium between the control group and study group (10.9 mm vs. 9.2 mm, respectively; P < 0.05). The biochemical pregnancy rate and ongoing pregnancy rate in the control group were significantly higher than those in the study group (51.4% vs. 31.7% and 37.8% vs. 18.3%, respectively; P < 0.05). In the study group, 28 (93.3%) patients had intrauterine adhesion (IUA) and 23 (76.7%) patients used an intrauterine device (IUD), which were both significantly higher than those in control group (P < 0.05). In addition, the rate of IUA in second-look hysteroscopy was lower than that in the first surgery in the study group (P < 0.05).
Conclusions: Patients with a history of GTD can present with a similar normal fertilization rate and number of viable embryos. However, patients with a history of GTD may have a thinner endometrium and lower ongoing pregnancy rate. Hysteroscopy before frozen embryo transfer and usage of an IUD can improve the occurrence of IUA. |
| first_indexed | 2024-12-12T14:45:08Z |
| format | Article |
| id | doaj.art-e19a7c1bc93b4bce92ce2524f6a86e4c |
| institution | Directory Open Access Journal |
| issn | 2096-2924 |
| language | English |
| last_indexed | 2024-12-12T14:45:08Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Health/LWW |
| record_format | Article |
| series | Reproductive and Developmental Medicine |
| spelling | doaj.art-e19a7c1bc93b4bce92ce2524f6a86e4c2022-12-22T00:21:08ZengWolters Kluwer Health/LWWReproductive and Developmental Medicine2096-29242018-01-0121384510.4103/2096-2924.232879The Clinical Outcomes of In Vitro Fertilization/Intracytoplasmic Sperm Injection Treatments in 43 Women with a History of Gestational Trophoblastic DiseaseXi ShenYan-Ping KuangBackground: To analyze the clinical outcomes of in vitro fertilization (IVF)/intracytoplasmic sperm injection treatments in women with a history of gestational trophoblastic disease (GTD). Methods: This retrospective study included 43 patients with a history of GTD as the study group and 43 matched patients as the control group. The patients in the study group were divided into two groups according to the therapy received. Patients in Subgroup A (n = 32) underwent uterine curettage treatment only. Patients in Subgroup B (n = 11) underwent uterine curettage combined with chemotherapy. The characteristics of ovarian stimulation and outcomes of embryos and pregnancy were compared. Results: In the first cycle, there was a higher number of retrieved oocytes and normal fertilized oocytes in the control group than those in the study group (9.2 vs. 6.2 and 6.0 vs. 4.0, respectively; P < 0.05); however, a similar mature oocyte rate (83.5% vs. 85.0%), normal fertilization rate (84.5% vs. 80.1%), number of good-quality embryos (1 vs. 2), and viable embryos (2 vs. 2) were found between the two groups (P > 0.05). There was no difference in the outcomes between Subgroup A and Subgroup B. There was a significant difference in thickness of the endometrium between the control group and study group (10.9 mm vs. 9.2 mm, respectively; P < 0.05). The biochemical pregnancy rate and ongoing pregnancy rate in the control group were significantly higher than those in the study group (51.4% vs. 31.7% and 37.8% vs. 18.3%, respectively; P < 0.05). In the study group, 28 (93.3%) patients had intrauterine adhesion (IUA) and 23 (76.7%) patients used an intrauterine device (IUD), which were both significantly higher than those in control group (P < 0.05). In addition, the rate of IUA in second-look hysteroscopy was lower than that in the first surgery in the study group (P < 0.05). Conclusions: Patients with a history of GTD can present with a similar normal fertilization rate and number of viable embryos. However, patients with a history of GTD may have a thinner endometrium and lower ongoing pregnancy rate. Hysteroscopy before frozen embryo transfer and usage of an IUD can improve the occurrence of IUA.http://www.repdevmed.org/article.asp?issn=2096-2924;year=2018;volume=2;issue=1;spage=38;epage=45;aulast=ShenChemotherapy; Gestational Trophoblastic Disease; In Vitro Fertilization/Intracytoplasmic Sperm Injection; Uterine Curettage Treatment |
| spellingShingle | Xi Shen Yan-Ping Kuang The Clinical Outcomes of In Vitro Fertilization/Intracytoplasmic Sperm Injection Treatments in 43 Women with a History of Gestational Trophoblastic Disease Reproductive and Developmental Medicine Chemotherapy; Gestational Trophoblastic Disease; In Vitro Fertilization/Intracytoplasmic Sperm Injection; Uterine Curettage Treatment |
| title | The Clinical Outcomes of In Vitro Fertilization/Intracytoplasmic Sperm Injection Treatments in 43 Women with a History of Gestational Trophoblastic Disease |
| title_full | The Clinical Outcomes of In Vitro Fertilization/Intracytoplasmic Sperm Injection Treatments in 43 Women with a History of Gestational Trophoblastic Disease |
| title_fullStr | The Clinical Outcomes of In Vitro Fertilization/Intracytoplasmic Sperm Injection Treatments in 43 Women with a History of Gestational Trophoblastic Disease |
| title_full_unstemmed | The Clinical Outcomes of In Vitro Fertilization/Intracytoplasmic Sperm Injection Treatments in 43 Women with a History of Gestational Trophoblastic Disease |
| title_short | The Clinical Outcomes of In Vitro Fertilization/Intracytoplasmic Sperm Injection Treatments in 43 Women with a History of Gestational Trophoblastic Disease |
| title_sort | clinical outcomes of in vitro fertilization intracytoplasmic sperm injection treatments in 43 women with a history of gestational trophoblastic disease |
| topic | Chemotherapy; Gestational Trophoblastic Disease; In Vitro Fertilization/Intracytoplasmic Sperm Injection; Uterine Curettage Treatment |
| url | http://www.repdevmed.org/article.asp?issn=2096-2924;year=2018;volume=2;issue=1;spage=38;epage=45;aulast=Shen |
| work_keys_str_mv | AT xishen theclinicaloutcomesofinvitrofertilizationintracytoplasmicsperminjectiontreatmentsin43womenwithahistoryofgestationaltrophoblasticdisease AT yanpingkuang theclinicaloutcomesofinvitrofertilizationintracytoplasmicsperminjectiontreatmentsin43womenwithahistoryofgestationaltrophoblasticdisease AT xishen clinicaloutcomesofinvitrofertilizationintracytoplasmicsperminjectiontreatmentsin43womenwithahistoryofgestationaltrophoblasticdisease AT yanpingkuang clinicaloutcomesofinvitrofertilizationintracytoplasmicsperminjectiontreatmentsin43womenwithahistoryofgestationaltrophoblasticdisease |