子宫内膜异位症影响体外受精-胚胎移植结局的初步探讨

The effects of endometriosis on the outcome of in vitro fertilization and embryo transfer:a preliminary study.

目的 探讨子宫内膜异位症的严重程度对体外受精 胚胎移植 (IVF ET)各个环节的影响。方法 对1999年 1月至 2 0 0 2年 4月在中山大学附属第一医院 10 7例已明确分期的子宫内膜异位症不育患者共 139周期IVF ET与同期输卵管因素不育患者 139例进行的 139周期IVF ET的控制性超排卵 (COH)治疗、受精率、卵裂率、每周期胚胎植入率和临床妊娠率、流产率等进行回顾性对照分析。结果 中、重度子宫内膜异位症不育患者与对照组相比进行IVF治疗时使用促性腺激素的总量增加而获卵数减少。重度患者雌二醇 (E2 )峰值下降 ,流产率增加 ,差异有统计学意义 (P <0 0 5 )。子宫内膜异位症不育患者IVF ET治疗时随着病情加重 ,卵巢对控制性超排卵的反应性下降 ,重度患者流产率增高。结论 子宫内膜异位症影响了卵子与胚胎的发育。

Objective To investigate whether the presence of endometriosis and the severity of this di sease will affect the outcome of in vitro fertilization and embryo transfer(IVF -ET).Methods A retrospective and comparative analysi s was performed in 107 endometriosis associated infertile patients who were stag ed by operati on and underwent 139 IVF-ET cycles.139 patients with tubal factor diagnosed as their sole cause of infertility and underwent 139 IVF-ET cycles i n the same period were recruited as control group.The outcome included numbers o f oocytes retrieved,peak oestradiol concentration on the day of HCG a dministration,numbers of gonadotrophin ampoules used per cycle,fertilization and so on.Results Compared with the control group,the number of retrieved oocytes and estradiol peak concentra tion in moderate and severe endometriosis infertile patients reduced,but the do ses of gonadotropin used in COH increased.The miscarriage rate of severe endome triosis patients was significantly higher compared with that of the other stages patients,P<0.05.As the severity of endometriosis increases,the ovarian res ponse to COH may be decreased.Severe endometriosis patients had high miscarriage rate. Conclusion The effects of endometriosis is on the development of th e oocyte and embryo.