国际生殖健康/计划生育杂志

国际生殖健康/计划生育杂志 ›› 2025, Vol. 44 ›› Issue (4): 293-296.doi: 10.12280/gjszjk.20250029

• 病例报告 • 上一篇    下一篇

原发性血小板增多症不孕患者IVF-ET成功分娩一例

张琪琪, 闫骏, 张桐, 刘真真, 周小琨, 姜爱芳()   

  1. 261042 山东省潍坊市，山东第二医科大学附属医院临床医学院（张琪琪，闫骏，周小琨）; 山东第二医科大学附属医院生殖医学中心（张桐，姜爱芳），血液科（刘真真）
  • 收稿日期:2025-01-13 出版日期:2025-07-15 发布日期:2025-07-28
  • 通讯作者: 姜爱芳，E-mail：wfjaf@sina.com

A Case of Successful Delivery through IVF-ET in An Infertile Patient with Essential Thrombocythemia

ZHANG Qi-qi, YAN Jun, ZHANG Tong, LIU Zhen-zhen, ZHOU Xiao-kun, JIANG Ai-fang()   

  1. School of Clinical Medicine, Affiliated Hospital of Shandong Second Medical University, Weifang 261042, Shandong Province, China (ZHANG Qi-qi, YAN Jun, ZHOU Xiao-kun); Center of Reproductive Medicine (ZHANG Tong, JIANG Ai-fang), Department of Hematology (LIU Zhen-zhen), Affiliated Hospital of Shandong Second Medical University, Weifang 261042, Shandong Province, China
  • Received:2025-01-13 Published:2025-07-15 Online:2025-07-28
  • Contact: JIANG Ai-fang, E-mail: wfjaf@sina.com

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摘要：

育龄期女性是原发性血小板增多症（essential thrombocythemia）发病率第二高的人群，该群体面临的生育挑战备受临床关注。报告1例原发性血小板增多症不孕患者通过体外受精-胚胎移植（in vitro fertilization-embryo transfer，IVF-ET）成功分娩的病例。患者因原发性不孕且促排卵无效接受IVF-ET助孕，治疗期间因血小板水平异常，多次调整用药方案。首次移植前后单用阿司匹林及后续阿司匹林联合低分子肝素钙治疗均未妊娠，调整治疗策略为先用阿司匹林联合α干扰素降低血小板水平，待血小板控制后，移植前后使用阿司匹林联合低分子肝素钙治疗，成功妊娠后持续该方案直至分娩前，最终顺利活产。通过探讨该病例临床特点、治疗方法及成功妊娠原因，强调个体化治疗方案在提高助孕成功率中的关键作用。

关键词: 血小板增多, 原发性, 不育, 女性, 体外受精, 胚胎移植, 治疗

Abstract:

Women of childbearing age are a group with the second highest incidence of essential thrombocythemia, and the reproductive challenges of this group have attracted clinical attention. We report a case of an infertile patient with essential thrombocythaemia who gave birth successfully through in vitro fertilization-embryo transfer (IVF-ET). The patient received IVF-ET due to primary infertility and ineffective ovulation induction. During the treatment, the medication regimen was adjusted multiple times due to abnormal platelet level. Aspirin alone before and after the first transplantation and aspirin combined with low molecular weight heparin calcium before and after the subsequent transplantation did not get successfully pregnancy. The treatment strategy was then adjusted to use firstly aspirin combined with interferon-α to reduce the platelet level. After platelet level was well controlled, aspirin combined with low molecular weight heparin calcium treatment was used before and after embryo transfer. After successful pregnancy, this regimen was continued until delivery. Ultimately, a successful live birth was achieved. By exploring the clinical characteristics, treatment methods and successful experience of this case, the key role of individualized treatment plan in improving the success rate of assisted pregnancy is emphasized.

Key words: Thrombocythemia, essential, Infertility, female, Fertilization in vitro, Embryo transfer, Therapy