The impact of previous history of malignant tumors/precancerous lesions on IVF/ICSI outcomes: a retrospective cohort study.
Women with a history of malignant tumors or precancerous lesions may experience lower live birth rates in IVF/ICSI, but multiple cycles can improve opportunities without significantly increasing tumor recurrence risk.
Where it sits
this study against the rest of the hcg (human chorionic gonadotropin) corpusSummary and findings
This study measured the impact of a history of malignant tumors or precancerous lesions on cumulative live birth rates (CLBR) in women undergoing IVF/ICSI. A total of 1004 patients were included, with 251 in the malignant tumors/precancerous lesions group. The conservative CLBR plateaued at around 53% after four cycles for this group.
Abstract
Background The incidence of malignant tumors/precancerous lesions is rising, yet their impact on pregnancy outcomes in women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) remains unclear. Methods A single-center retrospective cohort study was conducted at the Reproductive Medicine and Genetics Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology between January 2015 and December 2022. Propensity score matching (PSM) was applied to match the baseline data of the two groups, and the primary outcome were the conservative/optimistic cumulative live birth rates (CLBR) across multiple cycles. Results A total of 1004 patients were enrolled, including 251 individuals in the malignant tumors/precancerous lesions group (363 oocyte retrieval cycles) and 753 PSM controls (895 oocyte retrieval cycles). Compared with the controls, patients with a history of malignant tumors/precancerous lesions exhibited significantly lower ovarian reserve and poorer embryo outcomes (all p < 0.05). Both conservative and optimistic CLBR were lower in the malignant tumors/precancerous lesions group across multiple cycles (p < 0.05). After multiple oocyte retrievals, the conservative CLBR for malignant tumors/precancerous lesions plateaued at around 53% after four cycles, while optimistic CLBR reached 70% after four cycles. Among patients with prior malignant tumors/precancerous lesions who completed follow-up, the overall recurrence rate after IVF/ICSI treatment was 7.03% with no adverse events. Conclusions Patients with a previous history of malignant tumors/precancerous lesions demonstrated inferior live birth outcomes compared to controls. Multiple ovarian stimulations improved live birth opportunities without significantly increasing the risk of tumor recurrence.
Background
The paper addresses the clinical question of how a history of malignant tumors or precancerous lesions affects outcomes in in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Previous studies have indicated that such medical histories could influence reproductive success, but the extent and nature of this impact remain unclear. Understanding these effects is essential for guiding treatment decisions in affected patients.
Methods
This was a retrospective cohort study, but specific details regarding the population size (n), treatment protocols, duration, and outcome measures were not reported in the abstract. The study design aimed to compare IVF/ICSI outcomes based on patients' medical histories.
Results
Not reported in abstract.
Interpretation
Without specific results, it is challenging to compare these findings to existing literature or assess the clinical significance of any observed effects. The lack of detailed information raises concerns about potential confounding factors and the robustness of the conclusions drawn.
Key findings
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Limitations
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