Pal L, Shifren J L, Isaacson K B, Chang Y, Marean M, Leykin L, Toth T L
Division of Reproductive Endocrinology and Infertility, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
J Assist Reprod Genet. 1997 Oct;14(9):513-7. doi: 10.1023/a:1021175326230.
The outcome of in vitro fertilization (IVF) in a group of infertile women with a history of in utero exposure to diethylstilbestrol (DES) was analyzed. Records from an academic IVF program were retrospectively reviewed.
Seventeen infertile women with a self-reported history of exposure to DES in utero, attending the IVF unit at Massachusetts General Hospital (MGH) for assisted reproductive technology (ART), underwent 27 IVF cycles. Analysis of the outcome of IVF including implantation and ongoing pregnancy rates was performed. The data were compared with results from a group of 20 infertile patients with idiopathic infertility undergoing 27 IVF cycles at MGH during the same period. The patients in the two groups were matched for age, basal day 3 levels of follicle stimulating hormone and serum estradiol, and the number and quality of embryos transferred.
The response to controlled ovarian hyperstimulation was comparable in the two groups. Significantly lower implantation and ongoing pregnancy rates following IVF and embryo transfer were seen in the utero DES-exposed group compared to the control patients.
Infertile patients with a history of in utero exposure to DES exhibit a significantly impaired implantation rate following IVF, and the outcome of ART remains poor.
分析一组有宫内暴露于己烯雌酚(DES)病史的不孕女性的体外受精(IVF)结果。对一个学术性IVF项目的记录进行回顾性审查。
17名自述有宫内暴露于DES病史的不孕女性,在马萨诸塞州总医院(MGH)的IVF单元接受辅助生殖技术(ART),共进行了27个IVF周期。对IVF结果进行分析,包括着床率和持续妊娠率。将数据与同期在MGH进行27个IVF周期的20名特发性不孕不育患者的结果进行比较。两组患者在年龄、月经周期第3天的基础卵泡刺激素水平和血清雌二醇水平以及移植胚胎的数量和质量方面进行匹配。
两组对控制性卵巢过度刺激的反应相当。与对照组患者相比,宫内暴露于DES的组在IVF和胚胎移植后的着床率和持续妊娠率显著降低。
有宫内暴露于DES病史的不孕患者在IVF后着床率显著受损,ART的结果仍然较差。