卵巢子宫内膜异位症囊肿剥除术后复发与未复发患者IVF妊娠结局的初步比较

Comparison of IVF-ET outcomes between women with recurrent endometriomas and without recurrent endometriomas who had undergone an ovarian endometrioma cystectomy

目的:比较卵巢子宫内膜异位症(卵巢内异症)手术后囊肿复发与未复发患者接受体外受精-胚胎移植(IVFET)治疗的妊娠结局。方法:回顾性分析2012年1月—2016年12月在本院妇产科生殖中心行IVF-ET治疗,有卵巢内异症囊肿剥除术史的不孕症患者72例,其中卵巢内异症囊肿术后复发31例,未复发41例,比较两组的妊娠结局。结果:复发和未复发组间年龄、不孕年限、基础FSH、LH、E_2等基线指标无统计学差异。获卵数(7.9±5.1比7.2±5.3个,P=0.656)、受精率(89.0%比85.2%,P=0.204)、MⅡ卵率(86.1%比81.2%,P=0.133)、成胚率(88.2%比83.3%,P=0.127)及优胚率(36.3%比32.0%,P=0.348)无统计学差异。两组胚胎种植率(43.9%比43.2%,P=0.944)、临床妊娠率(57.1%比65.7%,P=0.486)、流产率(18.8%比26.1%,P=0.882)、活产率(46.4%比48.6%,P=0.866)、早产率(15.4%比23.5%,P=0.672)及低出生体重儿率(15.4%比23.5%,P=0.672)等差异均无统计学意义。结论:有卵巢内异症囊肿剥除术史的不孕患者术后是否囊肿复发对IVF-ET治疗的临床结局未见不良影响。

Objective： To compare IVF-ET outcomes between women with recurrent endometriomas and without recurrent endometriomas who had undergone an ovarian endometrioma cystectomy. Methods： A total of 72 infertile women who had previously undergone an ovarian endometrioma cystectomy before IVF-ET/ICSI cycles during January 2012 to December 2016 were retrospectively identified in reproductive medical center of Peking university first hospital. The selected patients were divided into two groups. 31 women with recurrent endometriomas were in experimental group, and 41 women without recurrent endometriomas were in control group. IVF-ET outcomes of patients in the two groups were compared. Results： There were no significant difference in baseline characteristics, such as age, years of infertility, and levels of FSH, LH, or E2 of patients. There were no significant difference in numbers of retrieved oocytes （7.9±5.1 VS. 7.2±5.3, P=0.656）, fertilization embryos rate （89.0% VS. 85.2%, P=0.204）, MⅡ oocytes rate （86. 1% VS. 81.2%,P=0.133）, embryos formation rate （88.2% VS. 83.3%,P=0.127）, and good quality embryos rate （36.3% VS. 32% ,P =0.348） between the two groups. There were also no significant difference in implantation rate （43.9% VS. 43.2%, P=0.944）, clinical pregnancy rate （57.1% VS. 65.7%, P=0.486）, miscarriage rate （18.8 VS. 26.1%, P=0.882）, live brith rate （46.4% VS. 48.6%, P=0.866）, preterm birth rate （15.4% VS. 23.5%, P= 0. 672） and low birth weight rate （15.4% VS. 23.5%, P =0.672） between the two groups. Conclusion.. Whether endo metrioma is recurrent of infertile women who undergone an ovarian endometrioma cystectomy maybe have no any harm impact on IVF-ET outcomes. Key words