轻度或中度子宫内膜异位症患者的体外受精不孕症治疗

Infertility treatment by in vitro fertilization in patients with minimal or mild endometriosis.

作者信息

Meden-Vrtovec H, Tomazevic T, Verdenik I

机构信息

Department of Obstetrics and Gynecology, University Medical Centre, Ljubljana, Slovenia.

出版信息

Clin Exp Obstet Gynecol. 2000;27(3-4):191-3.

PMID:11214948

Abstract

PURPOSE

To estimate the clinical effectiveness of in vitro fertilization treatment in patients with minimal or mild endometriosis (stages I and II) in comparison to the patients with tubal infertility in terms of fertilization, pregnancy and livebirth rates.

METHODS

Retrospective analysis of the outcome of IVF-ET in 612 cycles of the patients with endometriosis (389 stimulated with HMG/HCG and 223 co-treated with GnRH-a) and in 7,339 cycles of the patients with tubal infertility (5,520 stimulated with HMG/HCG and 1,819 co-treated with GnRH-a). RESULLTS: Regardless of the type of ovarian stimulation, the fertilization rate per treated cycle was practically the same in both groups (endometriosis 81.4% vs tubal infertility 84.2%; p = 0.07). However, in the endometriosis group the pregnancy rate was higher (25.3% vs 18.9%; p = 0.000), and so was the livebirth rate (19.0% vs 14.2%; p = 0.003). Considering the type of ovarian stimulation, the fertilization rate in the endometriosis group was almost the same in the HMG/HCG (81.2%) and in the GnRH-a co-treated cycles (81.6%), and did not differ from that in the tubal infertility group (83.6% in the HMG/HCG vs 85.9% in the GnRH-a cycles). In the GnRH-a co-treated cycles the pregnancy rate and the livebirth rate were not significantly higher in the endometriosis group than in the tubal infertility group (27% and 20.2% vs 22.2% and 17.5%). In the HMG/HCG stimulated cycles the pregnancy rate was significantly higher in the endometriosis than in the tubal infertility group (24.3% vs 17.7%; p = 0.004), and so was the livebirth rate (18.4% vs 13.0%; p = 0.008).

CONCLUSION

In patients with minimal or mild endometriosis the IVF-ET procedure is at least as effective as in patients with tubal infertility.

摘要

目的

比较体外受精治疗对轻度或中度子宫内膜异位症（I期和II期）患者与输卵管性不孕患者的受精、妊娠及活产率的临床有效性。

方法

回顾性分析612个周期的子宫内膜异位症患者（389个周期采用HMG/HCG刺激，223个周期联合GnRH-a治疗）及7339个周期的输卵管性不孕患者（5520个周期采用HMG/HCG刺激，1819个周期联合GnRH-a治疗）的体外受精-胚胎移植结局。结果：无论卵巢刺激类型如何，两组每个治疗周期的受精率实际相近（子宫内膜异位症组81.4% vs 输卵管性不孕组84.2%；p = 0.07）。然而，子宫内膜异位症组的妊娠率更高（25.3% vs 18.9%；p = 0.000），活产率也是如此（19.0% vs 14.2%；p = 0.003）。考虑卵巢刺激类型，子宫内膜异位症组HMG/HCG刺激周期（81.2%）和联合GnRH-a治疗周期（81.6%）的受精率相近，且与输卵管性不孕组无差异（HMG/HCG刺激周期中输卵管性不孕组为83.6%，联合GnRH-a治疗周期中为85.9%）。在联合GnRH-a治疗周期中，子宫内膜异位症组的妊娠率和活产率并不显著高于输卵管性不孕组（分别为27%和20.2% vs 22.2%和17.5%）。在HMG/HCG刺激周期中，子宫内膜异位症组的妊娠率显著高于输卵管性不孕组（24.3% vs 17.7%；p = 0.004），活产率也是如此（18.4% vs 13.0%；p = 0.008）。