子宫内膜异位症合并不孕患者生育指数与术后妊娠情况分析

Fertility Index and Postoperative Pregnancy Outcome in Infertile Patients with Endometriosis

目的对子宫内膜异位症合并不孕患者术后妊娠情况及生育指数进行分析。方法选择中山市博爱医院生殖内分泌科2014年1月至2015年6月子宫内膜异位症合并不孕患者114例,行腹腔镜手术,术中进行生育指数评分,术后随访12-18个月。随访术后妊娠情况。结果术后12-18个月累积妊娠率51.11%（58/114）,其中期待自然妊娠患者累积妊娠率44.44%（16/36）,促排卵-人工授精患者累积妊娠率52.00%（13/25）,体外授精-胚胎移植患者累积妊娠率54.71%（25/53）。期待自然妊娠的患者妊娠组生育指数（8.38±1.71）高于未妊娠组（7.50±1.00）,差异有统计学意义（P〈0.01）。促排卵-人工授精及体外授精-胚胎移植患者分别比较妊娠组与未妊娠组的生育指数,差异均无统计学意义（P〉0.05）。结论期待自然妊娠患者妊娠组的生育指数明显高于未妊娠组,说明生育指数增高有利于提高自然妊娠率。

Objective To analyze the postoperative pregnancy outcome and fertility index in infertile patients with endometriosis.Methods A prospective analysis was performed in 114 infertile patients with endometriosis who underwent laparoscopic surgery in the Department of Reproductive Endocrinology of Zhongshan Boai Hospital from January 2014 to June 2015.Fertility index was scored during operation and pregnancy outcome was investigate after 12-18 months of follow-up.Results At 12-18 months after operation,the cumulative pregnancy rate was 51.11%in all patients（58/114）,44.44%in patients who expected natural pregnancy（16/36）,52.00%in patients who underwent ovulation induction-artificial insemination（13/25）,and 54.71% in patients who underwent in vitro fertilization-embryo transplantation（25/53）.The fertility index in women who expected natural pregnancy（8.38±1.71）was significantly higher than that in nonpregnant women（7.50±1.00）（P〈0.01）.There was no significant difference in fertility index between women who underwent ovulation induction-artificial insemination and in pregnant women,as well as between women who underwent in vitro fertilization-embryo transplantation and non-pregnant patients（P〉0.05）.Conclusion The fertility index in women expecting natural pregnancy is significantly higher than that in non-pregnant women,indicating the high fertility index is conducive to improving the natural pregnancy rate.