卵巢子宫内膜异位囊肿剥除术对冻胚移植结局的影响

Effect of ovarian endometriosis cystectomy on the outcome of frozen embryo transplantation

目的探讨卵巢子宫内膜异位囊肿剥除术对卵巢型子宫内膜异位症(EMS)合并不孕症患者冻胚移植治疗结局的影响。方法收集353例卵巢EMS合并不孕症患者,其中手术组患者190例,非手术组患者163例,随机选取402例输卵管因素不孕症患者为对照组,回顾性分析比较3组患者接受冻胚移植治疗过程中临床资料、妊娠并发症和妊娠结局的差异。结果手术组和非手术组患者促性腺激素使用量均高于对照组(P<0.05),获卵总数、MⅡ期卵子数、卵裂数和获胚数均低于对照组(P<0.05)。手术组和非手术组患者促性腺激素使用量、获卵总数、MⅡ期卵子数、卵裂数和获胚数的差异无统计学意义(P>0.05)。手术组的胚胎着床率和临床妊娠率高于非手术组(P<0.05),三组患者异位妊娠率、流产率和活产率的差异无统计学意义(P>0.05)。手术组和非手术组的早产率及妊娠期糖尿病发生率高于对照组(P<0.05)。结论卵巢子宫内膜异位囊肿剥除术可以提高EMS不孕症患者冻胚移植治疗的胚胎着床率及临床妊娠率,但对活产率尚无改善。

Objective To investigate the effect of ovarian endometriosis cystectomy on the outcome of frozen embryo transfer in patients with ovarian endometriosis (EMS) complicated with infertility. Methods A total of 353 patients with ovarian endometriosis and infertility were enrolled,including 190 patients in the operation group and 163 patients in the non-surgical group. 402 patients with infertility due to tubal factors were randomly selected as the control group. Retrospective analysis three groups of patients received clinical data,pregnancy complications,and pregnancy outcomes during the treatment of frozen embryo transfer. Results The gonadotropin use in the ovarian endometriosis patients was higher than that in the control group ( P <0.05). The total number of eggs obtained,the number of eggs in the MⅡ phase,the number of cleavage,and the number of embryos obtained were low. In the control group ( P <0.05),there was no significant difference between the surgical group and the non-surgical group ( P >0.05). The implantation rate and clinical pregnancy rate of the operation group were higher than those of the non-surgical group ( P <0.05). There was no significant difference in ectopic pregnancy rate,abortion rate and live birth rate between the three groups ( P >0.05). The incidence of preterm birth and gestational diabetes in the surgical and non-surgical groups was higher than that in the control group ( P <0.05). Conclusion Ovarian endometriosis cystectomy can improve the implantation rate and clinical pregnancy rate of EMS infertility patients with frozen embryo transfer,but there is no improvement in live birth rate.