| 文琴,林冰,陈京京,等.双侧卵巢切除术后行冻融胚胎移植成功妊娠并分娩 1例[J].安徽医药,2025,29(10):1989-1992. |
| 双侧卵巢切除术后行冻融胚胎移植成功妊娠并分娩 1例 |
| Successful pregnancy and delivery after bilateral oophorectomy with frozen-thawed embryo transfer: a case report |
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| DOI：10.3969/j.issn.1009-6469.2025.10.015 |
| 中文关键词: 体外受精 -胚胎移植(IVF-ET) 卵巢交界性肿瘤 肿瘤种植 卵巢切除术 肿瘤标志物 |
| 英文关键词: In vitro fertilization-embryo transfer (IVF-ET) Borderline ovarian tumor(BOT) Neoplasm seeding Oophorectomy Tumor markers |
| 基金项目:广东医科大学顺德妇女儿童医院(佛山市顺德区妇幼保健院)青年人才项目( 2023QNRC017) |
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| 中文摘要: |
| 目的探讨卵巢交界性肿瘤病人在体外受精 -胚胎移植过程中发生腹腔种植后的诊疗策略，为临床提供经验借鉴。方法回顾性分析广东医科大学顺德妇女儿童医院的 1例 36岁再婚女性病人 2017—2021年诊疗经过。病人因继发性不孕行 IVF-ET治疗，术后 CA125急剧升高(从 35.4 U/L升至 880.6 U/L)，行腹腔探查发现卵巢交界性肿瘤伴腹腔广泛种植，遂行全面分期手术切除双侧卵巢及种植病灶，术后行激素替代治疗维持内膜，择期行冻融胚胎移植。结果病人术后病理确诊为双侧卵巢交界性黏液性囊腺瘤伴大网膜及肠管非浸润性种植。经激素替代治疗后行冷冻胚胎移植成功妊娠。孕期出现 8次出血，经保胎治疗后好转，最终于孕 36周早产顺产 1女婴，母婴健康。结论对于年轻卵巢交界性肿瘤病人，在充分评估病情的基础上可考虑保留生育功能的个体化治疗。 IVF-ET过程中应避免对性质不明的卵巢肿物进行穿刺，以防肿瘤细胞种植。双侧卵巢切除术后的 FET需要充分的激素替代和延长的黄体支持。 |
| 英文摘要: |
| Objective To explore the diagnostic and therapeutic strategies for patients with borderline ovarian tumors who developedperitoneal implantation during in vitro fertilization-embryo transfer (IVF-ET) procedures, and to provide clinical experience for refer-ence. Methods Retrospective analysis of the diagnosis and treatment process of a 36 year old remarried female patient at ShundeWomen and Children's Hospital of Guangdong Medical University from 2017 to 2021. The patient underwent IVF-ET for secondary in-fertility. Postoperatively, CA125 level dramatically increased from 35.4 U/L to 880.6 U/L. Exploratory laparotomy revealed borderlineovarian tumor with extensive peritoneal implantation. Comprehensive staging surgery was performed including bilateral oophorectomyand resection of implanted lesions. Hormone replacement therapy was administered postoperatively to maintain endometrial condition,followed by elective frozen embryo transfer (FET). Results Postoperative pathological results confirmed bilateral ovarian borderline mucinous cystadenoma with non-invasive implants in the omentum and intestines. Following hormone replacement therapy, the patientunderwent successful pregnancy through frozen embryo transfer. There were eight episodes of bleeding during pregnancy, which im-proved after conservative management. Ultimately, at 36 weeks of gestation, she had a preterm spontaneous vaginal delivery of a femaleinfant. Both mother and infant were healthy.Conclusions For young patients with borderline ovarian tumors, individualized fertility-preserving treatment may be considered based on comprehensive assessment of the disease status. During IVF-ET procedures, punc-ture of ovarian masses of uncertain nature should be avoided to prevent tumor cell implantation. FET following bilateral oophorectomy requires adequate hormone replacement therapy and prolonged luteal phase support. |
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