Reproductive outcomes of oocyte donation in patients with uterine Müllerian anomalies.

Autor:	Muñoz E; IVIRMA Global Research Alliance, IVIRMA Vigo, Reproductive Medicine, Vigo, Spain; Department of Obstetrics and Gynecology, Universidad del Cauca, Popayán, Colombia. Electronic address: elkin.munoz@ivirma.com., Fernández I; IVIRMA Global Research Alliance, IVIRMA Vigo, Reproductive Medicine, Vigo, Spain., Pellicer N; Department of Obstetrics and Gynecology, Hospital Politécnico la Fe, Valencia, Spain., Mariani G; IVIRMA Global Research Alliance, IVIRMA Roma, Reproductive Medicine, Roma, Italy., Pellicer A; IVIRMA Global Research Alliance, IVIRMA Roma, Reproductive Medicine, Roma, Italy., Garrido N; IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain.
Jazyk:	angličtina
Zdroj:	Fertility and sterility [Fertil Steril] 2023 Oct; Vol. 120 (4), pp. 850-859. Date of Electronic Publication: 2023 Jun 29.
DOI:	10.1016/j.fertnstert.2023.06.029
Abstrakt:	Objective: To evaluate live-birth rates per embryo transfer in patients with uterine Müllerian anomalies (UMAs). Secondary objectives were to compare reproductive outcomes between the normal uterus group, the different UMA types, and UMA subgroups with and without required surgery. Design: This retrospective study compared two cohorts, one with UMAs and other with normal uteri of our oocyte donation program at 12 Instituto Valenciano De Infertilidad/Reproductive Medicine Associates University affiliated clinics from January 2000 to 2020. The oocyte donation reduces confounding because of differences in embryo quality. The primary outcome was the live-birth rate per embryo transfer. Secondary outcomes included the rates of implantation, clinical pregnancy, miscarriage, and ongoing pregnancy. We calculated odds ratios with 95% confidence intervals. Patients: Infertile women undergoing oocyte donation with UMAs. Intervention: None. Main Outcome Measures: The rates of implantation, clinical pregnancy, miscarriage, ongoing pregnancy, and live birth. Results: We analyzed 58,337 cycles of oocyte donation: 57,869 patients had no uterine malformation, and 468 women had UMAs. Compared with patients with normal uteri, patients with UMAs had lower rates of live births (36.67% [32.84-40.65] vs. 38.1% [95% confidence intervals {CI}: 37.82-38.42]) and ongoing pregnancy (39.74% [35.93-43.66] vs. 41.5% [41.24-41.83]). The miscarriage rate was higher in patients with UMAs (19.5% [16.55-22.85] vs. 16.6% [16.47-16.92]). Specifically, patients with a unicornuate uterus (n=29) had lower rates of implantation (24.07% [13.49-37.64] vs. 42.85% [95% CI: 42.6-43.09]), pregnancy (41.86% [27.01-57.87] vs. 59.51% [59.22-59.81]), ongoing pregnancy (16.67% [6.97-31.36] vs. 41.54% [41.24-41.83]), and live births (16.67% [6.97-31.36] vs. 38.12% [37.83-38.42]). In addition, patients with a partial septate uterus (n=91) had a higher miscarriage rate (26.50% [18.44-34.89] vs. 16.7% [16.47-16.92]). Compared with the normal uterus group, the live-birth rates were lower in the UMA without surgery group (33.09% [27.59-38.96] vs. 38.12% [37.83-38.42]). Conclusion: Among patients who received embryos derived from donated oocytes, live birth and ongoing pregnancy rates were lower in patients with UMAs compared with patients with normal uteri. A higher miscarriage rate was found in patients with UMAs. Patients with a unicornuate uterus had worse reproductive outcomes. Our results show that the uterus is less competent in patients with UMAs. Trial Registration: This study was registered at clinicaltrial.gov (NCT04571671). Competing Interests: Declaration of interests E.M. has nothing to disclose. I.F. has nothing to disclose. N.P. has nothing to disclose. G.M. has nothing to disclose. A.P. has nothing to disclose. N.G. has nothing to disclose. (Copyright © 2023 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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