子宫内膜异位症不孕患者腹腔镜术后IVF-ET妊娠结局影响因素分析

Influence factor of IVF-ET pregnancy in infertile patients with endometriosis after laparoscopy treatment

目的分析子宫内膜异位症(EMT)不孕患者腹腔镜术后行IVF-ET助孕治疗妊娠结局的影响因素。方法选择2015年1月至2016年12月在本院生殖中心接受IVF-ET助孕的EMT不孕症腹腔镜术后患者141个周期作为研究对象,其中81个周期行新鲜胚胎/囊胚移植后成功妊娠纳入妊娠组,60个周期行移植后未妊娠纳入未妊娠组,对两组临床资料进行单因素及多因素Logistic回归分析,筛选出影响IVF-ET妊娠率的临床因素。结果 IVF-ET助孕的EMT不孕症腹腔镜术后患者中81个周期成功妊娠,妊娠率为57.45%。多因素Logistic回归分析显示,年龄、不孕年限、基础FSH及可移植胚胎数是影响EMT患者腹腔镜术后IVF-ET妊娠的独立因素,其中年龄<35岁、不孕年限<3年及基础FSH<10U/L是独立保护因素(OR值分别为0.491、0.494和0.350,P<0.05);可移植胚胎数<3个是独立危险因素(OR=2.860,P<0.05)。结论 EMT不孕患者腹腔镜术后行IVF-ET助孕可获得较好的妊娠结局,患者年轻、卵巢功能好、不孕时间短及IVF获得多的胚胎对提高妊娠率有益。

Objective ： To analyze the influence factors of IVF-ET pregnancy in infertile patients with endometriosis（EMT）after laparoscopy treatment.Methods ： The data of 141 IVF-ET cycles from EMT patients associated infertility after laparoscopy treatment in our reproductive center from January in 2015 to December in 2016 were retrospectively analyzed. Among them,81 cycles of the patients with successful pregnancy after embryos or blastocysts transferred were set as the pregnancy group. Another 60 cycles of the patients without pregnancy were arranged into the non-pregnancy group. The single factor or multi-factor logistic regression was used to analyze clinical data of the two groups. The influence factors of IVF-ET pregnancy rate were screened.Results ： Eighty-one cycles in EMT patients who underwent IVF-ET after laparoscopy treatment were successfully pregnant,and the overall pregnancy rate was 57.45%. The multi-factor logistic analysis showed that patients ’ age,infertility time,basal FSH and number of transplantable embryos were independent influence factors for IVF-ET pregnancy rate. Patients ’ age〈35 years old,infertility duration〈3 years,and basal FSH〈10 U/L were the protective factors（ OR =0.491,0.494,0.350, P 〈0.05）,and number of transplantable embryos〈3 was the independent risk factor（ OR =2.860, P 〈0.05）.Conclusions ： EMT patients associated infertility after laparoscopy treatment may obtain good pregnancy outcome with IVF-ET. Young age,good ovarian function,short time of infertility,more embryos available in IVF-ET can increase pregnancy rate.