卵巢子宫内膜异位囊肿对体外受精-胚胎移植的影响

Impact of ovarian endometrioma on in-vitro fertilization-embryo transfer

目的探讨卵巢子宫内膜异位囊肿对体外受精-胚胎移植(IVF-ET)的影响。方法对2002年1月至2006年12月在广州医学院第三附属医院行IVF-ET的120例(148周期)卵巢子宫内膜异位囊肿患者作回顾性分析。120例分别在降调节日和控制性超促排卵(COH)启动日行经阴道超声引导下卵巢子宫内膜异位囊肿穿刺术,将取卵日仍有卵巢子宫内膜异位囊肿患者46例(55周期)作为观察组,取卵日无卵巢子宫内膜异位囊肿患者74例(93周期)作为对照组。比较两组IVF-ET的结局。结果两组人绒毛膜促性腺激素(HCG)日雌二醇(E2)水平、移植胚胎数相似;观察组受精率[(61.5±23.6)%]、妊娠率(34.5%)稍低于对照组[(69.2±25.0)%,36.6%],但差异无显著性意义(P>0.05);观察组获卵数[(8.3±5.2)个]、优质胚胎数[(4.9±3.8)个]明显低于对照组[(10.5±7.6)个,(7.2±4.3)个](P<0.05);促性腺激素(Gn)总量明显高于对照组(P<0.05),取卵时间明显长于对照组(P<0.05)。结论卵巢子宫内膜异位囊肿对IVF-ET有一定的不良影响,导致Gn用量增加,取卵时间延长,获卵数和优质胚胎数减少。

Objective To investigate the impact of ovarian endometrioma on in-vitro fertilization-embryo transfer. Methods A retrospective analysis was conducted in 120 patients（ 148 cycles ） with ovarian endometrioma regarding their outcomes of undergoing in-vitro fertilization-embryo transfer （ IVF-ET ） in The Third Affiliated Hospital of Guangzhou Medical College from January 2002 to September 2006. The uhrasonographically guided puncturing and aspiration via vagina was performed on the majority of patients with ovarian endometrioma. The observation group consisted of 46 patients （55 cycles） with ovarian endometrioma on the day of retrieving oocytes. The control group consisted of 74 patients（ 93 cycles ） without ovarian endometrioma on the day of retrieving oocytes. Compare the outcomes of IVF-ET between two groups. Results No significant differences were observed in E2 level on the day of injecting HCG and number of embryos transferred between two groups. The observation group had slightly but not significantly higher rates of fertilization rate and pregnancy rate. The number of retrieved oocytes and the number of morphologically good-quality embryos in observation group were significantly less than that in control group. The total amount of Gn in observation group was significantly more than that in control group. The operation time of retrieving oocytes in observation group was significantly longer than that in control group. Conclusion The presence of ovarian endometrioma has a negative impact on IVF-ET, resulting in an increase in the total amount of Gn,the longer time of retrieving oocytes, and a decrease in the number of retrieved oocytes and morphologically good-quality embryos.