Ⅲ/Ⅳ期子宫内膜异位症不孕患者预处理对辅助生殖技术结果的影响

Effect of pretreatment on the outcome of assisted reproductive technology among patients with endometriosis-associated infertility at stage Ⅲ/Ⅳ

目的:分析预处理对子宫内膜异位症(EMs)不孕患者辅助生殖技术(ART)结果的影响。方法:回顾性分析238例行ART的Ⅲ/Ⅳ期EMs不孕患者的妊娠结局,观察未行预处理及两种不同预处理后的ART结局。结果:手术组、GnRHa预处理组及未处理组间行IVF超促排卵周期窦卵泡数目、Gn的剂量、用药时间、HCG日血清E2水平、内膜厚度、获卵数、成熟卵泡数、胚胎数、D1时2PN胚胎数、D3时1级胚胎数、妊娠率、累积妊娠率比较均无统计学差异(P>0.05)。结论:IVF前手术及GnRHa预处理并不能提高IVF成功率,若无明显手术指征,拟行辅助生殖技术之前行腹腔镜手术或者GnRHa治疗(间隔>3月)只会增加患者经济负担。

Objective：To analyze the effect of pretreatment on the outcome of assisted reproductive technology（ART） among patients with endometriosis-associated infertility. Methods：The pregnancy outcomes of 238 patients with endometriosis-associated infertility at stage Ⅲ/Ⅳ receiving ART were analyzed retrospectively,the outcomes of ART without pretreatment and with two different pretreatment methods were observed. Results：There was no significant difference in the number of antral follicle during IVF superovulation cycle,the dose of gonadotropic hormone,administration time,serum estradiol level on the day of human chorionic gonadotropin（HCG） injection,the depth of endometrium,the number of retrieved oocytes,the number of mature oocytes,the number of embryos,the number of 2PN embryos on the first day of HCG injection,the number of primary embryos on the third day of HCG injection,pregnancy rate and accumulative pregnancy rate among surgery group,GnRHa pretreatment group and non-pretreatment group（P0.05）. Conclusion：Surgery and GnRHa pretreatment before IVF can＇t increase the success rate of IVF,laparoscopic surgery or GnRHa treatment（the interval time3 months） before ART only can increase the economical burden of patients without apparent surgical indications.