子宫内膜异位症合并不孕患者经体外受精/卵胞质内单精子注射-胚胎移植治疗后妊娠结局及相关因素的分析

Analysis of pregnancy outcome and related factors after in vitro fertilization/intracytoplasmic sperm injection and embryo transfer treatment in infertility patients with endometriosis

目的探讨子宫内膜异位症(EMS)对不孕患者经体外受精/卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET)治疗后妊娠结局的影响及其与妊娠结局相关的因素。方法选择行IVF/ICSI-ET治疗的46例EMS合并不孕患者的55个取卵周期作为EMS组;选择同期行IVF/ICSI-ET治疗的126例非EMS患者的156个周期作为对照组。回顾性分析患者的临床资料,并进一步分析与妊娠结局相关的因素。结果 EMS组CA-125水平、周期取消率显著高于对照组(P<0.05);基础窦卵泡数(AFC)、hCG注射日成熟卵泡数、获卵数、MII卵数、双原核(2PN)数、卵裂数、优质胚胎数、优质胚胎率显著低于对照组(P<0.05);hCG注射日成熟卵泡数与EMS患者未妊娠的相关回归系数<0。结论 EMS合并不孕患者卵巢储备功能下降,卵子和胚胎质量下降,更易取消周期。但其卵子成熟率、正常受精率及临床结局与非EMS对照组不孕患者相比无统计学差异;hCG注射日成熟卵泡数是EMS患者妊娠的保护因素。

ObjectiveTo investigate the effects of endometriosis （EMS） on the outcome of pregnancy and the factors associated with pregnancy outcome after in vitro fertilization/intracytoplasmic sperm injection and embryo transfer （IVF/ICSI-ET） treatment in infertile patients.MethodsTotally 55 oocyte retrieval cycles of 46 cases of EMS associated with infertility patients were selected as EMS group. And 156 oocyte retrieval cycles of 126 cases of non EMS patients during the same period were selected as control group. The clinical data were analyzed between the two groups retrospectively, and a further analysis of the factors associated with pregnancy outcome in the two groups was performed.ResultsThe levels of CA-125 and the canceling rate of the cycle in EMS group was significantly higher than the control （P〈0.05）; basic antrol follicle count （AFC）, number of mature follicles on the hCG injection day, retrieved oocytes, MII oocytes, pronuclear （2PN）, normal cleavage, high-quality embryo and high-quality embryo rate in EMS group were significantly lower than those in the control （P〈0.05）. The correlation regression coefficient between number of mature follicles on hCG injection day and infertility outcomes in patients with EMS was less than 0.ConclusionOvarian reserve function in infertility patients with EMS is decreased, and the quality of eggs and embryos are decreased, which is more likely to cancel cycles. But the egg maturation rate, normal fertilization rate and clinical outcome in infertile patients with EMS have no significant difference when compared with infertility patients without EMS. The number of mature follicles on hCG injection day is the protective factor of pregnancy in EMS patients.