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Abstract：
OBJECTIVE: To examine the reproductive outcomes of assisted reproductive technology (ART) in gynecologic cancer patients and to assess maternal and neonatal complications.
METHODS: Women diagnosed with gynecologic cancer who underwent their first in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment between 2013 and 2021 at Shanghai Ji Ai Genetics and IVF Institute were included in this study. Infertile women without any history of cancer were matched to the cancer group. The primary outcome was the cumulative live birth rate. Baseline and follow-up data were compared between groups using Student\'s t-tests for normally distributed variables and with Chi-square test for categorical variables. A propensity score-based patient-matching approach was adopted to ensure comparability between individuals with and without specific cancer type.
RESULTS: A total of 136 patients with a history of gynecologic cancer and 241 healthy infertile controls were included in this study. Endometrial cancer constituted 50.70% of the cases and cervical cancer constituted 34.60% of the cases. The cancer group exhibited significantly shorter duration of stimulation, lower levels of estradiol, lower number of retrieved oocytes, day-3 embryos, and blastocysts compared to the control group (P < 0.05). The cumulative live birth rate of the gynecologic cancer group was significantly lower than that of the control group (36.10% vs. 60.50%, P < 0.001). Maternal and neonatal complications did not significantly differ between the groups (P > 0.05). The endometrial cancer and cervical cancer groups showed significantly lower cumulative live birth rates than their matched controls (38.60% vs. 64.50%, P = 0.011 and 24.20% vs. 68.60%, P < 0.001, respectively).
CONCLUSIONS: These findings highlight the decreased occurrence of pregnancy and live birth in female gynecologic cancer patients undergoing ART, particularly in endometrial cancers and cervical cancers. These findings have important implications for counseling and managing gynecologic cancer patients undergoing ART.
METHODS: Women diagnosed with gynecologic cancer who underwent their first in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment between 2013 and 2021 at Shanghai Ji Ai Genetics and IVF Institute were included in this study. Infertile women without any history of cancer were matched to the cancer group. The primary outcome was the cumulative live birth rate. Baseline and follow-up data were compared between groups using Student\'s t-tests for normally distributed variables and with Chi-square test for categorical variables. A propensity score-based patient-matching approach was adopted to ensure comparability between individuals with and without specific cancer type.
RESULTS: A total of 136 patients with a history of gynecologic cancer and 241 healthy infertile controls were included in this study. Endometrial cancer constituted 50.70% of the cases and cervical cancer constituted 34.60% of the cases. The cancer group exhibited significantly shorter duration of stimulation, lower levels of estradiol, lower number of retrieved oocytes, day-3 embryos, and blastocysts compared to the control group (P < 0.05). The cumulative live birth rate of the gynecologic cancer group was significantly lower than that of the control group (36.10% vs. 60.50%, P < 0.001). Maternal and neonatal complications did not significantly differ between the groups (P > 0.05). The endometrial cancer and cervical cancer groups showed significantly lower cumulative live birth rates than their matched controls (38.60% vs. 64.50%, P = 0.011 and 24.20% vs. 68.60%, P < 0.001, respectively).
CONCLUSIONS: These findings highlight the decreased occurrence of pregnancy and live birth in female gynecologic cancer patients undergoing ART, particularly in endometrial cancers and cervical cancers. These findings have important implications for counseling and managing gynecologic cancer patients undergoing ART.
摘要：
目的：研究辅助生殖技术（ART）在妇科癌症患者中的生殖结局，并评估母婴并发症。
方法：本研究包括2013年至2021年在上海集爱遗传和IVF研究所接受首次体外受精/卵胞浆内单精子注射（IVF/ICSI）治疗的被诊断为妇科癌症的女性。无任何癌症史的不孕妇女与癌症组相匹配。主要结果是累积活产率。使用正态分布变量的Student\'st检验和分类变量的卡方检验比较各组之间的基线和随访数据。采用基于倾向评分的患者匹配方法，以确保有和没有特定癌症类型的个体之间的可比性。
结果：本研究共纳入了136例有妇科癌症史的患者和241例健康不孕对照。子宫内膜癌占病例的50.70%，宫颈癌占病例的34.60%。癌症组表现出明显更短的刺激持续时间，较低水平的雌二醇，回收的卵母细胞数量较少，第3天的胚胎，囊胚与对照组比较(P<0.05)。妇科癌症组的累积活产率明显低于对照组(36.10%vs.60.50%,P<0.001)。母婴并发症组间差异无统计学意义(P>0.05)。子宫内膜癌和宫颈癌组的累积活产率显着低于其匹配的对照组（38.60％vs.64.50%,P=0.011和24.20%vs.68.60%,分别为P<0.001)。
结论：这些发现强调了接受ART的女性妇科癌症患者的妊娠和活产发生率下降，特别是子宫内膜癌和宫颈癌。这些发现对于接受ART的妇科癌症患者的咨询和管理具有重要意义。
方法：本研究包括2013年至2021年在上海集爱遗传和IVF研究所接受首次体外受精/卵胞浆内单精子注射（IVF/ICSI）治疗的被诊断为妇科癌症的女性。无任何癌症史的不孕妇女与癌症组相匹配。主要结果是累积活产率。使用正态分布变量的Student\'st检验和分类变量的卡方检验比较各组之间的基线和随访数据。采用基于倾向评分的患者匹配方法，以确保有和没有特定癌症类型的个体之间的可比性。
结果：本研究共纳入了136例有妇科癌症史的患者和241例健康不孕对照。子宫内膜癌占病例的50.70%，宫颈癌占病例的34.60%。癌症组表现出明显更短的刺激持续时间，较低水平的雌二醇，回收的卵母细胞数量较少，第3天的胚胎，囊胚与对照组比较(P<0.05)。妇科癌症组的累积活产率明显低于对照组(36.10%vs.60.50%,P<0.001)。母婴并发症组间差异无统计学意义(P>0.05)。子宫内膜癌和宫颈癌组的累积活产率显着低于其匹配的对照组（38.60％vs.64.50%,P=0.011和24.20%vs.68.60%,分别为P<0.001)。
结论：这些发现强调了接受ART的女性妇科癌症患者的妊娠和活产发生率下降，特别是子宫内膜癌和宫颈癌。这些发现对于接受ART的妇科癌症患者的咨询和管理具有重要意义。
