子宫内膜不典型增生及早期子宫内膜癌患者保守治疗后IVF/ICSI助孕结局OA

Objective:To explore the impact of atypical endometrial hyperplasia(AEH)and early endometrial carcinoma(EC)on the pregnancy and perinatal outcomes of in vitro fertilization/intracytoplasmic sperm injectionoutcomes(IVF/ICSI)after conservative treat-ment.Methods:48 patients with AEH/EC and 14948 women with no evidence of endometrial abnormality,who underwent their first autologous oocytes'retrieval cycles of IVF/ICSI at the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2018 to December 2024,were retrospectively enrolled.The two groups were matched at a ratio of 1:3 based on age,infertility duration,infertility type,infertility cause,antral follicle count(AFC),body mass index(BMI),and oocyte retrieval time using propensity score matching(PSM).The AEH/EC group included 46 patients,and the control group included 134 patients.The basic conditions,IVF/ICSI indicators,clinical pregnancy rate in fresh cycles,cumulative pregnancy rate,cumulative live birth rate,and the perinatal outcomes of the two groups were analyzed.Re-sults:Before PSM the AEH/EC group was older(32.79±3.96 vs 31.13±4.19,P=0.006),had a longer infertility duration(5.27±3.58 vs 3.57±2.70,P=0.000),a higher proportion of primary infertility(77.08％vs 47.87％,P=0.000),a lower AFC(13.48±8.05 vs 18.23±9.44,P=0.000),and a higher BMI(26.79±4.31 vs 23.83±3.43,P=0.000)compared with the control group.The main causes of infertility in the AEH/EC group were ovarian factors(50％)and tubal factors(25.00％),while they were tubal factors(53.04％)and male fac-tors(19.76％)in the control group,and the differences were statistically significant(P=0.000).After PSM,there were of no significant differences in the basic conditions(age,infer-tility duration,infertility type,AFC,BMI,and infertility cause)between the two groups(all P>0.05).Compared with the control group,the AEH/EC group had a shorter duration of gonado-tropins(Gn)used(10.16±2.51 vs 11.35±2.81,P=0.014),thinner endometrium on hCG day(7.88±2.47 vs 11.35±2.81,P=0.000),a higher rate of high-quality embryos(50.94％vs 48.17％,P=0.000),and a lower blastocyst formation rate(47.47％vs 62.22％,P=0.000).After PSM,the time to pregnancy in the AEH/EC group was longer than that in the control group(214.39±213.68 vs 136.01±86.37,P<0.05),but there were no significant differences in cumulative pregnancy rate,cumulative live birth rate,delivery mode,gestational age at deliv-ery,birth weight and the incidence of pregnancy complications between the two groups(all P>0.05).By the end of the last follow-up,the recurrence rate of the AEH/EC group was 4.17％(2/48).Conclusion:Satisfactory pregnancy outcomes can be achieved in patients with AEH/EC through IVF/ICSI without increasing the risk of preterm birth,low birth weight.