巨细胞病毒感染对体外受精-胚胎移植妊娠结局的影响
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摘要
目的:探讨巨细胞病毒(CMV)感染对不孕症患者行体外受精/胞浆内单精子注射(IVF/ICSI治疗妊娠结局的影响。方法:2005年8月—2018年1月间在本院进行辅助生殖治疗的59 536例患者,按是否感染CMV分为CMV IgG阳性组(94例)和CMV IgG阴性组(26 483例),分析CMV感染后对辅助生殖治疗患者妊娠结局的影响。结果:2组患者年龄、不孕时间、不育时间、体质量指数、基础卵泡刺激素(FSH)等比较差异均无统计学意义(P>0.05),但CMV IgG阳性组较CMV IgG阴性组IVF卵子数、IVF 2PN数、生化妊娠率和临床妊娠率均降低,差异有统计学意义(P<0.05)。结论:既往CMV感染后可降低患者行IVF-ET治疗的IVF卵子数、IVF2PN数、生化妊娠率和临床妊娠率。CMV IgG阳性对患者的IVF/ICSI结局有不良影响。
Objective:To investigate the effect of cytomegalovirus(CMV) infection on the pregnancy outcomes of IVF/ICSI treatment. Methods:The data of 59 536 patients who underwent ART treatment in our center between August 2005 and January 2018 were retrospectively analyzed. These patients were divided into two groups: the CMV IgG positive group(n=94) and the CMV IgG negative group(n=26 483). The pregnancy outcomes were compared accordingly. Results:There were no significantly differences in the age, infertile duration, body mass index, base level of FSH between the two groups(all P>0.05). The number of retrieved oocytes, the number of 2PN after IVF, the rate of biochemical pregnancy, and the rate of clinical pregnancy in the CMV IgG positive group were significantly lower than those in the CMV IgG negative group(all P<0.05). Conclusions:The number of retrieved oocytes, the number of 2PN after IVF, the rate of biochemical pregnancy, and the rate of clinical pregnancy could be lowered in those patients with the history of CMV infection. The CMV positive infection may affect the clinical outcomes of IVF/ICSI treatment.
Objective:To investigate the effect of cytomegalovirus(CMV) infection on the pregnancy outcomes of IVF/ICSI treatment. Methods:The data of 59 536 patients who underwent ART treatment in our center between August 2005 and January 2018 were retrospectively analyzed. These patients were divided into two groups: the CMV IgG positive group(n=94) and the CMV IgG negative group(n=26 483). The pregnancy outcomes were compared accordingly. Results:There were no significantly differences in the age, infertile duration, body mass index, base level of FSH between the two groups(all P>0.05). The number of retrieved oocytes, the number of 2PN after IVF, the rate of biochemical pregnancy, and the rate of clinical pregnancy in the CMV IgG positive group were significantly lower than those in the CMV IgG negative group(all P<0.05). Conclusions:The number of retrieved oocytes, the number of 2PN after IVF, the rate of biochemical pregnancy, and the rate of clinical pregnancy could be lowered in those patients with the history of CMV infection. The CMV positive infection may affect the clinical outcomes of IVF/ICSI treatment.
引文
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[15]琚端,张颖,李岩,等.巨细胞病毒Ig G阳性育龄妇女体液阳性情况研究[J].中国计划生育学杂志,2012,20(3):186.
[16]李崎,钱卫平,邹红艳,等.148例不孕不育妇女TORCH抗体检测[J].中国妇幼保健,2005,(10):1267-1268.
[17]吴爱成.1535例育龄妇女巨细胞病毒Ig G和Ig M抗体检测分析[J].临床和实验医学杂志,2011,10(13):996-997.
[18]陈华,李玲芳,程洁,等.人类巨细胞病毒感染与血脂代谢关键酶的关系[J].中国现代医学杂志,2010,20(24):3744-3748.
[19]李宣,丁卫,刘嘉茵,等.血脂异常对多囊卵巢综合征患者IVF/ICSI妊娠结局的影响[J].中华妇产科杂志,2018,53(6):402-408.
[2]Wang C,Zhang X,Bialek S,et al.Attribution of congenital cytomegalovirus infection to primary versus non-primary maternal infection[J].Clin Infect Dis,2011,52(2):e11-e13.
[3]Gardner DK,Schoolcraft WB,Wagley L,et al.A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization[J].Hum Reprod,1998,13(12):3434-3440.
[4]Griffiths P,Baraniak I,Reeves M.The pathogenesis of human cytomegalovirus[J].J Pathol,2015,235(2):288-297.
[5]Cannon MJ,Hyde TB,Schmid DS.Review of cytomegalovirus shedding in bodily fluids and relevance to congenital cytomegalovirus infection[J].Rev Med Virol,2011,21(4):240-255.
[6]Staras SA,Flanders WD,Dollard SC,et al.Cytomegalovirus seroprevalence and childhood sources of infection:A populationbased study among pre-adolescents in the United States[J].J Clin Virol,2008,43(3):266-271.
[7]Kenneson A,Cannon MJ.Review and meta-analysis of the epidemiology of congenital cytomegalovirus(CMV)infection[J].Rev Med Virol,2007,17(4):253-276.
[8]Nigro G,Adler SP.Cytomegalovirus infections during pregnancy[J].Curr Opin Obstet Gynecol,2011,23(2):123-128.
[9]Adler SP.Screening for cytomegalovirus during pregnancy[J].Infect Dis Obstet Gynecol,2011,2011:1-9.
[10]Aksu G,Genel F,Koturogˇlu G,et al.Serum immunoglobulin(IgG,Ig M,Ig A)and Ig G subclass concentrations in healthy children:a study using nephelometric technique[J].Turk J Pediatr,2006,48(1):19-24.
[11]裴蕴锋.小儿巨细胞病毒感染状况分析[J].检验医学与临床,2013,10(8):980-981.
[12]张曦,熊菀.巨细胞病毒感染诊治进展[J].儿科药学杂志,2014,20(6):51-54.
[13]Varani S,Landini MP.Cytomegalovirus-induced immunopathology and its clinical consequences[J].Herpesviridae,2011,2(1):6.
[14]Bassiouny YA,Dakhly DMR,Bayoumi YA,et al.Does the addition of growth hormone to the in vitro fertilization/intracytoplasmic sperm injection antagonist protocol improve outcomes in poor responders?A randomized,controlled trial[J].Fertil Steril,2016,105(3):697-702.
[15]琚端,张颖,李岩,等.巨细胞病毒Ig G阳性育龄妇女体液阳性情况研究[J].中国计划生育学杂志,2012,20(3):186.
[16]李崎,钱卫平,邹红艳,等.148例不孕不育妇女TORCH抗体检测[J].中国妇幼保健,2005,(10):1267-1268.
[17]吴爱成.1535例育龄妇女巨细胞病毒Ig G和Ig M抗体检测分析[J].临床和实验医学杂志,2011,10(13):996-997.
[18]陈华,李玲芳,程洁,等.人类巨细胞病毒感染与血脂代谢关键酶的关系[J].中国现代医学杂志,2010,20(24):3744-3748.
[19]李宣,丁卫,刘嘉茵,等.血脂异常对多囊卵巢综合征患者IVF/ICSI妊娠结局的影响[J].中华妇产科杂志,2018,53(6):402-408.