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手术剥除子宫内膜异位囊肿对IVF-ET结局的影响 被引量:4

Effect of Surgical Treatment for Endometrioma on In Vitro Fertilization-Embryo Transfer Outcomes
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摘要 目的:探讨子宫内膜异位囊肿手术剥除与否对IVF-ET结局的影响。方法:回顾性分析接受IVF-ET第1周期治疗的305例患者,分成子宫内膜异位囊肿手术组(A组)、子宫内膜异位囊肿未手术组(B组)和管性不孕对照组(C组),采用长、短方案进行超促排卵,比较3组的IVF结局。结果:无论刺激方案如何,A组平均获卵数低于B组与C组(P≤0.001),而FSH用量高于C组(P<0.001),A组妊娠率低于B组,B组妊娠率低于C组(P<0.05)。B组与C组相比,除FSH用量较高(P<0.001)外,获卵数、总胚胎数、优质胚胎率、可利用胚胎数3组间比较无统计学差异。此外,在A组中,手术侧卵巢平均获卵数低于健侧卵巢(P<0.01),且术侧卵巢未获卵的比例达24%。结论:子宫内膜异位囊肿患者IVF结局不良;手术剥除子宫内膜异位囊肿并不能改善IVF结局,反而降低了卵巢反应性。 Objective: To investigate the effect of endometrioma and stripping endometrioma on IVF-ET outcomes. Methods: A total of 305 cases receiving the first IVF cycle in our center were included in this retrospective study. They were divided into three groups, endometrioma-operated group, endometrioma group, tubal infertility group as the control. All these patients were divided into 2 subgroups according to different ovarian hyper- stimulation protocols (long protocol and short protocol). The outcomes of IVF were compared among the three groups. Results: In both protocols, the average number of retrieved oocytes in endometrioma-operated group was lower than that of endometrioma group and tubal infertility group (P ≤ 0.001). The endometrioma-operated group was also consuming significantly higher doses of FSH than that of the control (P〈0.001). Meanwhile, the pregnancy rate of endometrioma-operated group was lower than that of endometrioma group, the pregnancy rate of both the two groups was lower than that of the control (P〈0.05). Compared with the control, the endometrioma group consumed higher FSH dosage (P〈0.001), but the average number of retrieved oocytes and total number of embryos were comparable between the two groups. The three groups had no significant difference in the rate of good-quality embryos. In addition, in the endometrioma-operated group, the average number of retrieved oocytes from the operated ovaries was lower than that from the contralateral ovaries (P〈0.01), 24% of these patients did not retrieve eggs. Conclusion: Patients with endometrioma have poorer IVF outcomes, and surgical treatment for endometrioma cannot improve the IVF outcome, but to aggravate the damage to ovarian response.
出处 《生殖与避孕》 CAS CSCD 2013年第4期272-276,243,共6页 Reproduction and Contraception
关键词 子宫内膜异位症(EMs) 子宫内膜异位囊肿 体外受精 胚胎移植(IVF-ET) 囊肿剥除术 endometriosis endometrial cyst IVF-ET enucleation
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