Nghiên cứu đặc điểm lâm sàng, cận lâm sàng và đánh giá kết quả điều trị vô sinh nữ bằng phương pháp thụ tinh trong ống nghiệm tại bệnh viện quốc tế phương châu năm 2019

T P CHÍ CH CC NT S 33/2020 V K T LU N T l m l y thai nhóm theo phân lo i Robson 29,73% Các y u t c i có màu xanh hay vàng; thi u i; vào phòng sanh n chuy n d ti m th i s d ng Oxytocin chuy n d khác bi ng kê v i p < 0,05 TÀI LI U THAM KH O yên, (2011), (2017), u tình hình m l y thai t i B nh vi n Trung i h c Y Hu Lu Hu , T (2017), - 2017 Hatigan Robson Michael, Murphy M, (2013), Methods of achieving and maintaining an appropriate caesarean section rate, Best Pract Res Clin Obstet Gynaecol, 27, pp 297 - 308 Selin L, Almström E, Wallin G, and et al, (2009), Use and abuse of oxytocin for augmentation of labor, Acta obstetricia et gynecologica Scandinavica, 88 (12), pp 1352-1357 Vindevoghel N, Betrán A.P, Souza J.P, (2014), Asystematic review of the Robson classification for caesrean section: What works, dosen't work and how to improve it, PloS one (6), pp 977 World Health Organization, (2010), Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-2008, Lancet, 375, pp 490-499 10 Wagner M.V, Chin V.P, Peters C.J, and et al, (1989), A comparison of early and delayed induction of labor with spontaneous rupture of membranes at term, Obstetrics & Gynecology, 74 (1), pp 93-97 (Ngày nh n bài: 4/8/2020 - Ngày 1* *Email: bsngoc1705@gmail.com - 119 T P CHÍ CH CC NT S 33/2020 h nh ABSTRACT STUDY ON CLINICAL, SUBCLINICAL CHARACTERISTICS AND THE RESULTS OF TREATMENT FEMALE INFERTILITY BY IN VITRO FERTILIZATION AT PHUONG CHAU INTERNATIONAL HOSPITAL IN 2019 Du Huynh Hong Ngoc1*, Pham Van Linh2, Cao Van Nhut3, Tran Khanh Nga2 Phuong Chau International Hospital Can Tho University of Medicine and Pharmacy Can Tho University of Medicine and Pharmacy Hospital Background: In vitro fertilization (IVF) is a process that creates embryos outside the body human Currently, the average success rate is about 40-50 percent There are many factors affecting the results of treatment Besides, the tests to evaluate ovarian reserve are still controversial and prognosis, which of pregnancy results have not been tested clearly Objectives: To descrise clinical, subclinical characteristics and cumulative pregnancy outcome in two frozen embryo transfer cycles Materials and methods: Women have received IVF treatment at Phuong Chau International Hospital from March, 2019 to March, 2020 Studying design: Cross-sectional description, there are currently 180 clients in IVF treatment process with transfers of frozen embryos Results: Average age in observed group was 32.21 ± 4.0, AMH value was 4.64 ± 2.78, number of secondary AFC cysts was 15.53 ± 5.67, classified as primary infertility was 65.6% and secondary infertility the number of recovered eggs was 34.4% The pregnancy rates for the first and second embryo transfer were 43.3% and 63.9%, respectively The prevalece of the first biochemical pregnancy was 18.3%, the second time was 10.0%; The rate of clinical pregnancy were 23.3% and 51.1%, respectively; The result of two cumulative frozen embryo transfer was 78.2%; clinical pregnancy rate was 63.3% Conclusion: An ovarian stimulation cycle for IVF, IF we had embryos transfer, the rate of clinical pregnancy was 63.3% Keywords: In vitro fertilization, cumulative pregnancy - 120 T P CHÍ CH CC NT S 33/2020 Follicle Count- - noãn (noãn) -3/2020 - L =35 121 T P CHÍ CH CC NT S 33/2020 m Tu i 35 Lo i vô sinh Vô sinh nguyên phát Vô sinh th phát T n s (n=180) 32,21±4,0 57 79 44 T l (%) 118 62 65,6 34,4 32,21±4,0 31,7 43,9 24,4 - * m T n s (n) T l (%) 14 143 23 7,8 79,4 12,8 5,28±4.07 97 24 59 53,9 13,3 32,8 175 32 57 97,2 2,8 17,8 1,1 31,7 BMI (kg/m ) i 18 T n 25 Trên 25 Th i gian mong Th i gian mong trung bình T Nguyên nhân vô sinh Do ch ng V l n tu i B nh lý vịi nỗn Khác 122 T P CHÍ CH CC NT S 33/2020 Nh n xét: BMI gi i h ng chi m t l 79.4% V th i gian mong m t l cao nh m 32,8% Nguyên nhân hi m mu n nam gi i chi m t l t tr i 97,2% * Các tri u ch ng liên quan vô sinh hi m mu n B ng Tri u ch ng g p m Kinh nguy t u u Tri u ch T n s (n) T l (%) 118 62 65,6 34,4 21 159 11,7 88,3 11 169 6,1 93,9 13 167 7,2 92,8 u u Không có Ti t s a b Có Khơng có ng p Khơng có Nh n xét: Kinh nguy u chi p 7,2% Khơng có ti t s a 93,9% Xét nghi m d tr bu ng tr ng AFC (ngày 2-ngày vòng kinh) AMH (ng/ml) Giá tr nh nh t 0,7 u chi m t l th p Giá tr l n nh t 31 18,6 Trung bình l ch chu n 15,53 ± 5,67 4,64 ± 2,78 n xét: Xét nghi m liên quan N N S Giá tr nh nh t 627 dày NMTC ngày r ng tr ng Estradiol ngày r ng tr ng (pg/ml) Progesterone ngày r ng tr ng (pg/ml) ng tr ng NMTC trung bình 11,55 ± 2,38 13,79 ± 6,19 123 Giá tr l n nh t 26 19384 45 Trung bình l ch chu n 11,55 ± 2,38 4643,18 ± 2806,4 1,46 ± 0,892 13,79 ± 6,19 T P CHÍ CH CC NT * xét: * 124 S 33/2020 T P CHÍ CH CC NT S 33/2020 -AFC phôi * B 3.3.1 K t qu sau chuy n phôi l n B ng K t qu chuy n phôi l n n=180 T l th thai T l thai lâm sàng** T l thai sinh hóa T l thai ngồi t cung T n s (n) 78 42 33 * 125 T l (%) 43,3 23,3 18,3 1,7 T P CHÍ n=180 T l th thai T l thai lâm sàng** T l thai sinh hóa T l thai ngồi t cung CH CC NT S 33/2020 T n s (n) 115 92 18 * T l (%) 63,9 51,1 10,0 2,8 n m K t qu th thai hCG c ng d n Có nh t l n beta HCG (+) Beta HCG (-) K t c c thai c ng d n Có nh t l n có thai lâm sàng Khơng có thai lâm sàng sau l n chuy n phôi T n s (n=180 ) T l (%) 141 39 78,3 21,7 114 66 63,3 36,7 78, ,3% 35 Nhóm tu i >35 T T T T ns l ns l Khơng có thai lâm sàng 46 38,7% 20 32,8% Ít nh t 01 l n có thai lâm sàng 73 61,3% 41 67,2% OR 1,29 (0,67 2,47) p 0,272 ,5% nhóm >35 ,258 , tro gian 126 T P CHÍ CH CC NT S 33/2020 rong 50% vô [3], [4], [8], [10] - 8[5 8- 127 , khơng T P CHÍ CH CC NT S 33/2020 xác y 32,21±4,0 nỗn thu - TÀI L , -24 - , -25 -47 Abdullah, R K., Liu, N., Zhao, Y., Shuang, Y., Shen, Z., Zeng, H., & Wu, J (2020) Cumulative live-birth, perinatal and obstetric outcomes for POSEIDON groups after IVF/ICSI cycles: a single-center retrospective study Scientific RepoRtS, 10(1), pp 1-13 Asada, Y., Morimoto, Y., Nakaoka, Y., Yamasaki, T., Suehiro, Y., Sugimoto & Irahara, M (2017), predictor of the ovarian response, Reproductive medicine and biology, 16(4), pp 364-373 Fréour, T., Barrière, P., & Masson, D (2017), Anti-müllerian hormone levels and evolution in women of reproductive age with breast cancer treated with chemotherapy, European journal of cancer, (74), pp 1-8 Iliodromiti, S., Anderson, R A., & Nelson, S M (2015), Technical and performance characteristics of anti-Müllerian hormone and antral follicle count as biomarkers of ovarian response, Human reproduction update, 21(6), pp 698-710 Kano, M., Sosulski, A E., Zhang, L., Saatcioglu, H D., Wang, D., Nagykery, N., & Pépin, D (2017), AMH/MIS as a contraceptive that protects the ovarian reserve during 128 T P CHÍ CH CC NT S 33/2020 chemotherapy, Proceedings of the National Academy of Sciences, 114(9), pp 1688-1697 10 Landersoe, S K., Forman, J L., Birch Petersen, K., Larsen, E C., Nøhr, B., Hvidman, H W., & Nyboe Andersen, A (2020) Ovarian reserve markers in women using various hormonal contraceptives, The European Journal of Contraception & Reproductive Health Care, 25(1), pp 65-71 11 Polyzos, N P., Drakopoulos, P., Parra, J., Pellicer, A., Santos-Ribeiro, S., Tournaye, H., & Garcia-Velasco, J (2018), Cumulative live birth rates according to the number of oocytes retrieved after the first ovarian stimulation for in vitro fertilization/intracytoplasmic sperm injection: a multicenter multinational analysis including 15,000 women Fertility and sterility, 110(4), 661-670 12 Tarín, J J., Pascual, E., Pérez-Hoyos, S., Gómez, R., García-Pérez, M A., & Cano, A (2020), Cumulative probabilities of live birth across multiple complete IVF/ICSI cycles: a call for attention, Journal of Assisted Reproduction and Genetics, 37(1), pp 141-148 (Ngày nh n bài: 21/9/2020 - Ngày 0/2020) M TS M C N LÂM SÀNG VÀ K T QU K T C C THAI K THAI TO T I B Chung C m Ng c1*,Võ Hu nh Trang2, Phan H u Thúy Nga2 B nh vi C nT ih cC *Email: ngockhai09@gmail.com TÓM T T tv : Trong su t trình mang thai tr ng thai nhi v c th y thu c thai ph u Tr u t quan tr th y thu c cân nh c l a ch nh phòng tai bi n c a m sau sanh M c tiêu nghiên c u: Tìm hi u m t s mc t qu k t c c thai k thai to u: Nghiên c u c c th c hi n 322 thai ph thai to v i tu i thai t 37 tu n tr lên t i b nh vi C K t qu nghiên c u: Có 322 thai ph gram tham gia nghiên c m c n lâm sàng k t c c thai k nh, chi c i, Hemoglobin Glucose máu, Apgar phút sau sinh, tình tr ng m bé sau sinh K t lu n: i gian g n bi c thai to s ki m c tai bi n c a m sau sinh T khóa: Thai to ABSTRACT PARACLINICAL AND OUTCOME OF MACROSOMIA AT CAN THO CENTRAL GENERAL HOSPITAL Chung Cam Ngoc1*, Võ Huynh Trang2, Phan Huu Thuy Nga2 Can Tho Central General Hospital Can Tho University of Medicine and Pharmacy Background: During pregnancy, fetal weight is always a top concern of physicians and pregnant women Fetal weight is also an important factor for physicians to consider choosing the wrong way to give birth to prevent complications of the mother and baby after birth Objectives: 129 ... (noãn) -3/2020 - L =35 121 T P CHÍ CH CC NT S 33/2020 m Tu i 35 Lo i vô sinh Vô sinh nguyên phát Vô sinh th phát T n s (n=180) 32,21±4,0 57 79 44 T l (%) 118 62 65,6 34,4 32,21±4,0... th thai T l thai lâm sàng* * T l thai sinh hóa T l thai ngồi t cung T n s (n) 78 42 33 * 125 T l (%) 43,3 23,3 18,3 1,7 T P CHÍ n=180 T l th thai T l thai lâm sàng* * T l thai sinh hóa T l thai... n có thai lâm sàng Khơng có thai lâm sàng sau l n chuy n phôi T n s (n=180 ) T l (%) 141 39 78,3 21,7 114 66 63,3 36,7 78, ,3% 35 Nhóm tu i >35 T T T T ns l ns l Khơng có thai lâm sàng 46 38,7%