| 摘要: |
| ［摘要］ 目的 比较浆液性卵巢交界性肿瘤（SBOT）与黏液性卵巢交界性肿瘤（MBOT）患者在保留生育手术后接受体外受精助孕的促排卵反应、胚胎学与妊娠结局，并评估肿瘤复发安全性。方法 回顾性分析2010年5月至2023年5月在中山大学附属第六医院生殖医学中心行体外受精（IVF）/卵泡浆内单精子显微注射技术（ICSI）治疗的63例卵巢交界性肿瘤（BOT）保留生育手术后患者的临床资料。根据术后病理类型分为SBOT组44例和MBOT组19例。比较两组促排卵指标、胚胎学指标、移植周期情况及妊娠结局，并以Firth校正的多因素logistic回归分析肿瘤复发相关因素。结果 两组基线特征、促排卵方案、受精方式、促性腺激素（Gn）总天数、Gn总用量、获卵数、2PN数、可移植胚胎数、优质胚胎数、每卵2PN率、每卵可移植胚胎率、每卵优质胚胎率比较差异均无统计学意义（P>0.05）。MBOT组新鲜周期胚胎移植比例显著低于SBOT组（P<0.05），两组无可移植胚胎周期率、移植胚胎数、移植周期数、每移植周期活产率及每起始周期活产率比较差异均无统计学意义（P>0.05）。7例失访。SBOT组复发率为10.53%（4/38），MBOT组复发率为5.56%（1/18），两组复发率比较差异无统计学意义（χ2=0.012，P=0.911）。Firth校正的多因素logistic回归分析结果显示，病理类型并非肿瘤复发的独立影响因素。结论 保留生育手术后SBOT与MBOT患者接受IVF/ICSI助孕的促排卵反应、胚胎学表现及妊娠结局总体相当，不同病理类型BOT复发风险无统计学差异。 |
| 关键词: 浆液性卵巢交界性肿瘤 黏液性卵巢交界性肿瘤 保存生育手术 体外受精 胚胎移植 肿瘤复发 |
| DOI：10.3969/j.issn.1674-3806.2026.03.06 |
| 分类号: |
| 基金项目:广东省医学会临床科研基金生殖专项项目（编号：2025SZ-B1001） |
|
| Comparison of the outcomes of IVF/ICSI cycles and tumor recurrence between SBOT and MBOT patients after fertility-sparing surgery |
|
LI Yujie1, WU Jialin1, SUN Wenchao2, LI Jingjie1
|
|
1.Center for Reproductive Medicine, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510520, China; 2.Department of Gynecology, Binzhou People′s Hospital, Binzhou 256610, China
|
| Abstract: |
| ［Abstract］ Objective To compare the ovarian response to controlled ovarian stimulation, embryological and pregnant outcomes between serous borderline ovarian tumor(SBOT) patients and mucinous borderline ovarian tumor(MBOT) patients who underwent fertility-sparing surgery(FSS) followed by in vitro fertilization(IVF), and to evaluate the safety regarding tumor recurrence. Methods A retrospective analysis was conducted on the clinical data of 63 patients with borderline ovarian tumor(BOT) who underwent in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI) in Center for Reproductive Medicine, the Sixth Affiliated Hospital, Sun Yat-sen University from May 2010 to May 2023 after FSS. According to the pathological types after the surgery, the patients were divided into SBOT group(44 cases) and MBOT group(19 cases). The ovarian stimulation parameters, embryological indicators transplantation cycles and pregnant outcomes were compared between the two groups. Firth-corrected multivariable logistic regression was used to analyze the factors associated with tumor recurrence. Results There were no statistically significant differences between the two groups in terms of baseline characteristics, ovulation induction protocol, fertilization method, days using gonadotropin(Gn), the total dosage of Gn, the number of oocytes retrieved, the number of two-pronuclear(2PN) fertilized oocytes, the number of transferable embryos, the number of high-quality embryos, the rate of 2PN ferlilization per egg, the rate of transferable embryos per egg and the rate of high-quality embryos per egg(P>0.05). The proportion of fresh cycle embryo transfer in the MBOT group was significantly lower than that in the SBOT group(P<0.05). There were no significant differences between the two groups in the non-transplantable embryo cycle rate, number of transplanted embryos, number of transplantation cycles, live birth rate per transfer cycle and live birth rate per initiated cycle(P>0.05). Seven patients were lost to follow-up. The recurrence rate was 10.53%(4/38) in the SBOT group and 5.56%(1/18) in the MBOT group, and the difference was not statistically significant between the two groups(χ2=0.012, P=0.911). Firth-corrected multivariable logistic regression analysis suggested that pathological type was not an independent influencing factor for tumor recurrence. Conclusion The ovarian response to controlled ovarian stimulation, embryological manifestations and pregnant outcomes followed by IVF/ICSI in SBOT and MBOT patients who underwent fertility-sparing surgery were comparable. There is no significant difference in the recurrence risk between the two different pathological types of BOT. |
| Key words: Serous borderline ovarian tumor(SBOT) Mucinous borderline ovarian tumor(MBOT) Fertility-sparing surgery(FSS) In vitro fertilization Embryo transfer Tumor recurrence |
