助孕时机对子宫内膜异位症不孕患者术后妊娠率的影响

The influence of the timing of assisted reproduction on the pregnancy rate of patients with endometriosis associated infertile

目的：探讨助孕时机的选择对子宫内膜异位症不孕患者术后妊娠的影响。方法：选取2010年3月～2014年1月在本院就诊并行子宫内膜异位症合并不孕治疗的患者287例。根据患者术后治疗方案不同分为A、B、C、D组。A组术后直接试孕；B组术后试孕达12个月未孕后接受辅助生殖治疗；C组术后经药物治疗3个月后直接试孕；D组术后药物治疗3个月后行辅助生殖治疗。比较各组妊娠率。结果：4组患者术后2年的妊娠率，与A组比较，B组和D组的2年总妊娠率、Ⅲ期、Ⅳ期患者妊娠率均明显增高（P〈0．05）；B组、c组、D组各组间各项两两比较无差异（P〉0．05）；A组Ⅲ期、Ⅳ期患者术后2年妊娠率低于I～Ⅱ期患者（P〈0．05）。结论：临床上在对此类患者治疗时需考虑综合评估患者情况，在经济条件及生理状况允许下，术后1年内采取辅助生殖治疗能够确保术后较高的妊娠率，增加Ⅲ期、Ⅳ期患者的受孕机会。

Objective： To analysis the influence of the timing of assisted reproduction on the pregnancy rate of patient after endometriosis operation. Method： Totally 287 patients with endometriosis associated infertile received treatment in Air Force General Hospital of the Chinese People＇s Liberation Army from March 2010 to January 2014 were recruited and were divided into four groups （A,B, C and D groups） according to their therapeutic regimen endometriosis after operation. Patients in group A had tried to conceive directly. Patients in group B were given assisted reproduction after 12 months of operation. Patients in group C had tried to conceive after drug therapied for 3 months postoperative. Patients in group D were given assisted reproduction after drug therapy for 3 months endometriosis postoperative. Result： In 2 years＇ observation, the total pregnancy rate, pregnancy rate of women with endometriosis III and IV stage in group B and group D were significantly higher than those of group A （P 〈 0.05）. There was no statistically significant difference among B group, C group and group D （P 〉 0. 05）.The pregnancy rate of women with endometriosis III, IV stage in group A were significant lower than that of endometriosis I, II stage （P 〈 0.05）. Conclusion：It is necessary to consider comprehensive evaluation of patient situation when proving clinical treatment. If economic conditions and physiological conditions allows, implementing assisted reproduction in one year after endometriosis operation will improve the rate of pregnancy of patients with endometriosis III and IV stage.