Otoinflamatuar veya Otoimmün Hastalıkları Olan 60 Kadında İn Vitro Fertilizasyon: Tek Merkez Deneyimi

Öz

Amaç: Otoimmün ve otoinflamatuar hastalıklar, kadınların gebe kalma zamanlamasını ve yeteneğini geciktirebilmektedir. Bugüne kadar, otoimmün ve otoinflamatuar hastalıklar ile ilişkili infertilitede İn Vitro Fertilizasyonun (IVF) sonuçlarına ilişkin çok az veri mevcuttur. Mevcut çalışmada, en sık görülen tiroid bezine karşı otoimmün hastalıklar dışında otoimmün hastalıklardan veya otoinflamatuar hastalıklardan en az birine sahip kadınlarda IVF deneyimini bildirdik. Gereç ve Yöntemler: En az bir otoimmün veya otoinflamatuar hastalığı olan ve 2014 ile 2023 yılları arasında en az bir IVF prosedürü geçirmiş kadınlar üzerinde retrospektif bir analiz yapıldı. Bulgular: Çalışmaya toplam 74 IVF uygulanan 60 kadın dahil edildi. Hastaların %26,6' sını etkileyerek romatoid artrit en sık karşılaşılan otoimmün hastalık olup bunu %25 ile Ailesel Akdeniz Ateşi izledi. Azalmış overyan rezervi infertilitenin birincil nedeniydi ve örnek popülasyonun %64,9'unu etkiledi. IVF sırasındaki ortalama yaş 33 idi. Yetmişdört IVF siklusunun 15'inde gebelik elde edildi, bunun 9'u canlı doğum (%60) ve 6'sı abortus (%40) ile sonuçlandı. IVF klinik gebelik oranı %20,2, canlı doğum oranı ise %12,1 olarak gerçekleşti. Obstetrik komplikasyonlar arasında preterm doğum, preeklampsi ve fetal büyüme kısıtlılığından oluşan birer vaka yer alıyordu. Anne veya yenidoğan ölümü yaşanmadı ve overyan hiperstimülasyon sendromu vakası bildirilmedi. Sonuç: Bu çalışmada otoimmün ve otoinflamatuar hastalıkları olan 60 hastada IVF sonuçlarını analiz ettik. IVF prosedürü, nispeten düşük gebelik ve canlı doğum oranları gösterdi. Bununla birlikte, devam eden gebeliklerin yarıdan fazlası canlı doğum ile sonuçlanmıştır. IVF, otoimmün-otoinflamatuar hastalıkları olan hastalarda doğurganlık tedavisi için umut verici bir seçenek olmaya devam etmektedir.

Anahtar Kelimeler

• otoimmün
• otoinflamatuar
• tüp bebek
• kısırlık
• gebelik

In Vitro Fertilization in 60 Women with Auto-inflammatory or Uncommon Autoimmune Diseases: A Single-Center Experience

Öz

Objective: Autoimmune and auto-inflammatory diseases can affect both the timing and ability of women to conceive. There is limited data addressing the outcomes of in vitro fertilisation (IVF) in autoimmune and auto-inflammatory-related infertility. This study presents the IVF experience in women diagnosed with at least one auto-inflammatory disease or autoimmune disorder except for the more common autoimmune disorders that primarily impact the thyroid gland. Material and Methods: A retrospective analysis was performed on women diagnosed with at least one autoimmune or auto-inflammatory disease and had undergone at least one IVF cycle between 2014 and 2023. Results: The study included 60 women who underwent a total of 74 IVF procedures. Rheumatoid arthritis was the most common autoimmune condition, affecting 26.6% of the patients, closely followed by Familial Mediterranean Fever (FMF) in 25% of the patients. The main factor causing infertility in the sample population was the diminished ovarian reserve, which affected around 64.9% of the participants. The median age at the time of IVF was 33 years. Out of 74 IVF cycles, there were 15 pregnancies, resulting in 9 live births (60%) and 6 miscarriages (40%). The IVF clinical pregnancy rate was 20.2% and the live birth rate was 12.1%. Obstetric complications included one case each of preterm birth, preeclampsia, and fetal growth restriction. No maternal or neonatal deaths occurred, and no cases of ovarian hyperstimulation syndrome were reported. Conclusion: The outcomes of IVF in 60 patients diagnosed with autoimmune and auto-inflammatory diseases were analysed in this study. The IVF procedure exhibited comparatively low pregnancy and live birth rates. However, more than half of the on-going pregnancies resulted in live births. IVF remains a promising option for fertility treatment in patients with autoimmune diseases.

Anahtar Kelimeler

• autoimmune
• auto-inflammatory
• in-vitro fertilization
• infertility
• pregnancy

Kaynakça

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