Brit J Cancer:IVF卵巢刺激与BRCA1/2突变携带者原发性乳腺癌风险!

2018-06-26 xing.T MedSci原创

由此可见,没有证据表明IVF时卵巢刺激与BRCA1/2突变携带者乳腺癌风险之间存在关联。

很少有研究评估体外受精(IVF)对BRCA1/2突变携带者乳腺癌风险的影响。由于携带者可能越来越多地接受IVF。近日,肿瘤领域权威杂志British Journal of Cancer上发表了一篇研究文章。研究人员评估了IVF卵巢刺激对BRCA1/2突变携带者患乳腺癌风险的影响。

研究人群由1550例BRCA1突变和964例BRCA2突变携带者组成,这些携带者来自全国HEBON研究和全国植入前基因诊断(PGD)登记中心。研究人员使用问卷调查、临床记录和与荷兰癌症登记处联系分别收集IVF、风险降低手术和癌症诊断的数据。研究人员进行了时间依赖性Cox回归分析,对出生队列进行分层并针对不育情况进行调整。

在2514例BRCA1/2突变携带者中,3%(n=76)的携带者暴露于IVF卵巢刺激。总共有938例BRCA1/2突变携带者(37.3%)被诊断患有乳腺癌。IVF暴露与乳腺癌风险无关(HR为0.79,95%CI为0.46-1.36)。亚低生育的妇女(n=232; HR为0.73,95%CI为0.39-1.37)和BRCA1突变携带者(HR为1.12,95%CI为0.60-2.09)的亚组也得到了类似的结果。此外,第一次IVF治疗的年龄和新近程度与乳腺癌风险无关。

由此可见,没有证据表明IVF时卵巢刺激与BRCA1/2突变携带者乳腺癌风险之间存在关联。

原始出处:

Inge A. P. Derks-Smeets,et al. Ovarian stimulation for IVF and risk of primary breast cancer in BRCA1/2 mutation carriers.British Journal of Cancer. 2018. https://www.nature.com/articles/s41416-018-0139-1

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    2019-05-24 qblt
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createdName=gaoxiaoe, createdTime=Thu Nov 22 15:42:00 CST 2018, time=2018-11-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1846676, encodeId=1fd418466e626, content=<a href='/topic/show?id=d3a33e0306d' target=_blank style='color:#2F92EE;'>#原发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37030, encryptionId=d3a33e0306d, topicName=原发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8e4c53, createdName=jiyangfei, createdTime=Fri Apr 19 19:42:00 CST 2019, time=2019-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2025669, encodeId=f0052025669e6, content=<a href='/topic/show?id=4bd836838e5' target=_blank style='color:#2F92EE;'>#卵巢刺激#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36838, 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621450, encodeId=5766162145083, content=<a href='/topic/show?id=1c3b36890d' target=_blank style='color:#2F92EE;'>#BRCA1/2突变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3689, encryptionId=1c3b36890d, topicName=BRCA1/2突变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=085920261380, createdName=jiyangfei, createdTime=Thu Jun 28 09:42:00 CST 2018, time=2018-06-28, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2004917, encodeId=b9c4200491e06, content=<a href='/topic/show?id=2f48569264d' target=_blank style='color:#2F92EE;'>#携带者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56926, encryptionId=2f48569264d, topicName=携带者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=640c454, createdName=qblt, createdTime=Fri May 24 15:42:00 CST 2019, time=2019-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1770300, encodeId=eb421e703002f, content=<a href='/topic/show?id=df9c23e868a' target=_blank style='color:#2F92EE;'>#乳腺癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23786, encryptionId=df9c23e868a, topicName=乳腺癌风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9538161180, 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href='/topic/show?id=da4e368832' target=_blank style='color:#2F92EE;'>#BRCA1/2#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3688, encryptionId=da4e368832, topicName=BRCA1/2)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=63ce11226326, createdName=fangcong, createdTime=Thu Jun 28 09:42:00 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1594033, encodeId=abce1594033de, content=<a href='/topic/show?id=63cc368459' target=_blank style='color:#2F92EE;'>#BRCA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3684, encryptionId=63cc368459, topicName=BRCA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Thu Jun 28 09:42:00 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621450, encodeId=5766162145083, content=<a href='/topic/show?id=1c3b36890d' target=_blank style='color:#2F92EE;'>#BRCA1/2突变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3689, encryptionId=1c3b36890d, topicName=BRCA1/2突变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=085920261380, createdName=jiyangfei, createdTime=Thu Jun 28 09:42:00 CST 2018, time=2018-06-28, status=1, ipAttribution=)]
    2019-02-03 sjq027
  6. [GetPortalCommentsPageByObjectIdResponse(id=2004917, encodeId=b9c4200491e06, content=<a href='/topic/show?id=2f48569264d' target=_blank style='color:#2F92EE;'>#携带者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56926, encryptionId=2f48569264d, topicName=携带者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=640c454, createdName=qblt, createdTime=Fri May 24 15:42:00 CST 2019, time=2019-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1770300, encodeId=eb421e703002f, content=<a href='/topic/show?id=df9c23e868a' target=_blank style='color:#2F92EE;'>#乳腺癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23786, encryptionId=df9c23e868a, topicName=乳腺癌风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9538161180, 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621450, encodeId=5766162145083, content=<a href='/topic/show?id=1c3b36890d' target=_blank style='color:#2F92EE;'>#BRCA1/2突变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3689, encryptionId=1c3b36890d, topicName=BRCA1/2突变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=085920261380, createdName=jiyangfei, createdTime=Thu Jun 28 09:42:00 CST 2018, time=2018-06-28, status=1, ipAttribution=)]
    2018-06-28 yeaweam
  7. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621450, encodeId=5766162145083, content=<a href='/topic/show?id=1c3b36890d' target=_blank style='color:#2F92EE;'>#BRCA1/2突变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3689, encryptionId=1c3b36890d, topicName=BRCA1/2突变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=085920261380, createdName=jiyangfei, createdTime=Thu Jun 28 09:42:00 CST 2018, time=2018-06-28, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=2004917, encodeId=b9c4200491e06, content=<a href='/topic/show?id=2f48569264d' target=_blank style='color:#2F92EE;'>#携带者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56926, encryptionId=2f48569264d, topicName=携带者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=640c454, createdName=qblt, createdTime=Fri May 24 15:42:00 CST 2019, time=2019-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1770300, encodeId=eb421e703002f, content=<a href='/topic/show?id=df9c23e868a' target=_blank style='color:#2F92EE;'>#乳腺癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23786, encryptionId=df9c23e868a, topicName=乳腺癌风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9538161180, 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href='/topic/show?id=da4e368832' target=_blank style='color:#2F92EE;'>#BRCA1/2#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3688, encryptionId=da4e368832, topicName=BRCA1/2)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=63ce11226326, createdName=fangcong, createdTime=Thu Jun 28 09:42:00 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1594033, encodeId=abce1594033de, content=<a href='/topic/show?id=63cc368459' target=_blank style='color:#2F92EE;'>#BRCA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3684, encryptionId=63cc368459, topicName=BRCA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Thu Jun 28 09:42:00 CST 2018, time=2018-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621450, encodeId=5766162145083, content=<a href='/topic/show?id=1c3b36890d' target=_blank style='color:#2F92EE;'>#BRCA1/2突变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3689, encryptionId=1c3b36890d, topicName=BRCA1/2突变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=085920261380, createdName=jiyangfei, createdTime=Thu Jun 28 09:42:00 CST 2018, time=2018-06-28, status=1, ipAttribution=)]
    2018-06-28 fangcong
  9. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621450, encodeId=5766162145083, content=<a href='/topic/show?id=1c3b36890d' target=_blank style='color:#2F92EE;'>#BRCA1/2突变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3689, encryptionId=1c3b36890d, topicName=BRCA1/2突变)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=085920261380, createdName=jiyangfei, createdTime=Thu Jun 28 09:42:00 CST 2018, time=2018-06-28, status=1, ipAttribution=)]
    2018-06-28 智智灵药
  10. 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研究目的是,基于夫妇的具体特点和治疗信息,建立一个预测模型,评估多个完整周期体外受精(IVF)的活产机会。 研究纳入1999-2008年期间,使用自己的卵子和丈夫的精子进行IVF(包括卵母细胞胞浆内单精子注射)的253417例女性。 使用两个临床预测模型评估最多六个完整周期IVF的活产机会。其中一个模型是根据IVF治疗前的信息预测,另一个则是根据首次IVF治疗期间的额外信息进行预测。

Hum Reprod:卵巢刺激性和非刺激性IVF对新生儿活产率和围生期结局有影响吗?

卵巢刺激会影响IVF治疗后早产儿(PTB)和低出生体重儿(LBW)的围生期结局吗?尽管目前的研究显示IVF中,卵巢刺激与否对PTB和LBW没有显著的统计学差异,但并不能排除卵巢刺激对IVF后围生期结局的影响。接受辅助生殖治疗ART的妊娠相比自然妊娠有更高比例的妊娠并发症,考虑到潜在的不孕和体外受精技术。判断卵巢刺激对于达到活产的影响效应和是否卵巢刺激常规应用于IVF引起了我们的兴趣,以及与无刺激的

Lancet:宫腔镜能改善反复IVF失败女性的活产率吗?(TROPHY)

目前体外受精(IVF)的成功率仍然很低,许多女性需要接受多个治疗周期才能成功妊娠。先前的荟萃分析表明,宫腔镜检查可以改善反复植入失女性的预后;不过研究质量差,需要一个明确的随机试验。所以我们进行了此项TROPHY试验,旨在评估宫腔镜检查能否提高反复植入失女性进行IVF治疗后的活产率。研究者在英国、比利时、意大利和捷克的8家医院进行了这项多中心、随机对照试验。纳入了<38岁、B超显示子宫腔正常、既往

Hum Reprod Update:GnRH拮抗剂方案与激动剂长方案在IVF应用中的效果对比。

在一般IVF人群中,与激动剂长方案相比,GnRH拮抗剂处理的持续妊娠率更低,但OHSS发病率也更低。在该人群中,拮抗剂治疗可以预防每40个患者中一个OHSS,同时减少每28人中一例持续妊娠。GnRH激动剂长方案的标准疗法仍是治疗过早黄体化的选择。在PCOS和卵巢反应不佳的患者群体重,GnRH拮抗剂未见对持续妊娠率造成影响,又鉴于其可以降低OHSS的发病率,因此,可以考虑将GnRH拮抗剂作为标准治疗