The role of colchicine treatment on reproductive outcome in women with Familial Mediterranean Fever

Abstract

Öz Amaç: Bu çalışma, Ailevi Akdeniz Ateşi (AAA) tanısı alan ve kolşisin tedavisi verilen kadınların üreme sonuçlarını karşılaştırmak amacıyla planlandı. Gereç ve Yöntem: AAA tanılı 40 infertil kadın kolşisin tedavisi alıp almadığına bakılmaksızın iki gruba ayrıldı. 29 AAA hastası düzenli kolşisin tedavisi alırken, 11 hasta kolşisin tedavisi almıyordu. Hastalara tüp bebek kliniğimize başvurmadan önce AAA tanısı kondu. Tüm hastalar, hormonal profili, semen analizi ve histerosalpingografi (HSG) dahil olmak üzere baseline kısırlık incelemesine tabi tutuldu. Katılımcılara standart antagonist protokole göre ovulasyon stimülasyonu başlandı. Çalışmamızın birincil sonuç ölçütleri, klinik gebelik yüzdesi, abortus oranları, devam eden gebelik, canlı doğum ve term doğum oranları olarak belirlendi. Bulgular: HSG'de üç tür problem tespit ettik; (i) peritubal adezyon (ii) periovaryan adezyon ve (iii) hidrosalpinks. HSG'deki anormal bulgular nedeniyle 11 hastaya laparoskopi yapıldı. Kolşisin grubunda 8 olguda adezyon, kolşisin verilmeyen hastalarda ise 3 olguda adezyon tespit edildi. Kolşisin grubunda 8 vakada hidrosalpinks tespit edilirken, kolşisin almayanlarda sadece 1 vakada tespit edildi. Douglas poşundaki asit her iki grupta da ultrasonografi veya laparoskopi ile tespit edildi. Kolşisin almayan hastalarda, kolşisin alan hastalara göre klinik gebelik anlamlı derecede yüksek bulundu. Düşük oranları açısından iki grup arasında anlamlı fark yoktu. Kolşisin grubunda erken doğum oranları anlamlı olarak düşük bulunurken, zamanında doğum oranları kolşisin grubunda kontrol grubuna göre anlamlı olarak yüksek bulundu. Sonuç: Term gebeliklerin sayısı üzerindeki olumlu etkisi dışında, kolşisin tedavisinin üreme sonuçları üzerinde herhangi bir olumsuz etkisi tespit edemedik. Abstract Aim: This study was planned to compare the reproductive outcome of women diagnosed with Familial Mediterranean Fever (FMF) who were given colchicine treatment and those who were not. Material and Method: Forty infertile women with FMF were divided into two groups whether they received colchicine treatment or not. While 29 FMF patients received regular colchicine treatment 11 patients did not receive colchicine treatment. The patients were diagnosed with FMF before applying to our IVF clinic. All patients were subjected to full infertility work-up, including hormonal profile, semen analysis and hysterosalpingography (HSG). All women with FMF were treated according to a standard antagonist protocol. The primary outcome measures were the percantage of clinical pregnancy (CPR), miscarraige rates, ongoing pregnancy, live birth and term birth rates. Results: We detected three types of problems in HSG; (i) peritubal adhesion (ii) periovarian adhesion and (iii) hydrosalpinx. Eleven patients underwent laparoscopy due to abnormal findings in HSG. Adhesion was detected in 8 cases in the colchicine group, while adhesion was detected in 3 cases in the patients who were not given colchicine. Hydrosalpinx was detected in 8 cases in the colchicine group, while it was detected in only one case in those who did not take colchicine. Ascites in the Douglas pouch was detected ultrasonographically or by laparoscopy in both groups. The CPR was found to be significantly higher in patients who did not receive colchicine compared to patients who received colchicine. There was no significant difference between two groups in terms of miscarraige rates. While preterm birth rates were found to be significantly lower in the colchicine group term birth rates were significantly higher in colchicine group compared to control group. Conclusion: Except for the positive effect on the number of term pregnancies we could not detect any negative effect of the colchicine treatment on the reproductive outcome.

Keywords

• FMF
• , Coochicine
• Birth rates
• Miscarriage rates

Project Number

yok

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