子宫内膜异位症影响体外受精-胚胎移植的具体环节探讨

Effects of endometriosis on in vitro fertilization and embryo transfer.

目的 探讨子宫内膜异位症 (内异症 )对体外受精 -胚胎移植 (IVF ET)的影响。方法 回顾性分析85例输卵管因素不孕的患者 (A组 ,12 3个周期 )、18例卵巢子宫内膜异位囊肿的患者 (B组 ,2 5个周期 )和 16例无卵巢子宫内膜异位囊肿的内异症患者 (C组 ,2 0个周期 )的获卵数、受精率、卵裂率、胚胎种植率和临床妊娠率等情况。结果 B组的获卵数为 (7 1± 5 9)个 ,非常显著地少于A组的 (11 6± 8 4)个和C组的 (12 1± 7 8)个 ,P <0 0 1;B组和C组的受精率分别为 6 9 5 %和 70 3% ,均显著地低于A组的 77 5 % ,P <0 0 5 ;A、B、C三组的卵裂率、子宫内膜的厚度与类型、胚胎种植率和临床妊娠率均无显著差别。结论 子宫内膜异位囊肿影响卵巢对超排卵的反应 ,内异症影响卵子的受精 ,但不影响受精卵的分裂、子宫内膜容受力、胚胎种植率和临床妊娠率。

Objective To investigate the effects of endometriosis on in vitro fertilization and embryo transfer(IVF ET)and the cause of infertility of women with endometriosis.Methods 85 cases with tubal factor infertility(group A,123 cycles),18 cases with ovarian endometriomas(group B,25 cycles)and 16 cases with endometriosis but without ovarian endometriomas(group C,20 cycles)were analysed.The numbers of harvested oocytes,fertilization rates,cleavage rates,thickness and types of endometrium,implantation rates,and clinical pregnancy rates were compared among the three groups.Results The patients in group B had a clearly smaller number of harvested ooctytes than those in group A and group C,(7\^1±5\^9) vs (11\^6±8\^4) and (12\^1±7\^8),P<0\^01.The patients in group A had a higher fertilization rate than those in group B and group C(77\^5% vs 69\^5% and 70\^3%,P<0\^05).The endometrial receptivity,cleavage,implantation,and pregnancy rate between the three groups showed no significant difference.Conclusion Our results suggest that women with ovarian endometriomas have a lower harvested oocytes number compared with those without.Women with endometriosis have a lower fertilization rates than those without.However,once the oocytes fertilized,it seems that the fertilized oocytes have a normal chance of cleavage,implantation,leading to similar pregnancy rate.