交界性或浸润性卵巢肿瘤患者保守治疗后接受辅助生殖技术的安全性研究(法国)

来源 :世界核心医学期刊文摘(妇产科学分册) | 被引量 : 0次 | 上传用户:momoww
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Objective. -Ovulation induction, the usual resort of Assisted Reproductive Technologies (ART), has been suspected of carrying a responsibility in the genesis of ovarian tumours. For patients with a borderline or invasive ovarian tumour, treated by conservative surgery and desiring to become pregnant, the problem is thus of a possible resort to the Assisted Reproductive Technologies. Patients and methods. -This is a multicenter, national and retrospective study. 40 operated patients between January 1971 and January 2001 have been included. 27 patients (67.5% ) had a borderline tumour, 10 (25% ) a non-epithelial tumour (germinal or stromal) and 3 (7.5% ) an epithelial invasive carcinoma. All these patients have benefited from a conservative surgical management of fertility. The Assisted Reproductive Technologies were simple stimulation for 5 women and IVF for the 35 others. The effectiveness and the risks of Assisted Reproductive Technologies have been estimated respectively by the number of pregnancies obtained and the recurrence rates. Results. -With a global follow-up of 372 months (January 1971: date of the primary surgical procedure -June 2002: closing of the study), 17 patients have obtained 17 pregnancies with the Assisted Reproductive Technologies, rate of 42.5% (17/40): 1 spontaneous abortion, 16 delivery with 23 children (triple pregnancies and 3 twin pregnancies). 3 patients treated for a borderline tumour have had a recurrence after induction of ovulation. Among the 40 patients, no one presented an evolved disease at the last news. The patients who had a recurrence had a delay to begin the Assisted Reproductive Technologies significantly lower than the patients who had no recurrence. Discussion and conclusion. -The assisted reproductive technologies for patients who had been treated for a borderline or invasive ovarian tumour, and who were infertile in spite of conservative management, have allowed 42.5% of these women to obtain a pregnancy and does not seem to increase significantly the risk of recurrence. Objective. -Ovulation induction, the usual resort of Assisted Reproductive Technologies (ART), has been suspected of carrying a responsibility in the genesis of ovarian tumours. For patients with a borderline or invasive ovarian tumor, treated by conservative surgery and desiring to become pregnant , the problem is thus a possible resort to the Assisted Reproductive Technologies. Patients and methods. - This is a multicenter, national and retrospective study. 40 operated patients between January 1971 and January 2001 have been included. 27 patients (67.5%) had All of these patients have benefited from a conservative surgical management of fertility. The Assisted Reproductive Technologies were simple stimulation (10%) a borderline tumor, 10 (25%) a non-epithelial tumor (germinal or stromal) and 3 for 5 women and IVF for the 35 others. The effectiveness and the risks of Assisted Reproductive Technologies have been estimated respectively by the numbe r of pregnancies obtained and the recurrence rates. Results -With a global follow-up of 372 months (January 1971: date of the primary surgical procedure-June 2002: closing of the study), 17 patients have obtained 17 pregnancies with the Assisted Reproductive Technologies, rate of 42.5% (17/40): 1 spontaneous abortion, 16 delivery with 23 children (triple pregnancies and 3 twin pregnancies). 3 patients treated for a borderline tumor have had a recurrence after induction of ovulation. Among the 40 patients, no one presented an evolved disease at the last news. The patients who had a recurrence had a delay to begin the Assisted Reproductive Technologies significantly lower than the patients who had no recurrence. Discussion and conclusion. -The assisted reproductive technologies for patients who had been treated for a borderline or invasive ovarian tumor, and who were infertile in spite of conservative management, have allowed 42.5% of these women to obtain a pregnancy and does not seem to increase significantly risk the recurrence.
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