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腹腔镜下子宫内膜异位囊肿切除术不影响卵巢对促性腺激素刺激的反应。

Laparoscopic ovarian cystectomy of endometriomas does not affect the ovarian response to gonadotropin stimulation.

作者信息

Marconi Guillermo, Vilela Martín, Quintana Ramiro, Sueldo Carlos

机构信息

Instituto de Ginecología y Fertilidad, Buenos Aires, Argentina.

出版信息

Fertil Steril. 2002 Oct;78(4):876-8. doi: 10.1016/s0015-0282(02)03326-5.

Abstract

OBJECTIVE

To evaluate the ovarian response cycles of IVF-ET in patients who previously underwent laparoscopic cystectomy for endometriomas.

DESIGN

Retrospective study with prospective selection of participants and controls.

SETTING

Instituto de Ginecología y Fertilidad Buenos Aires, Argentina.

PATIENT(S): Thirty-nine patients underwent an operation for ovarian endometriomas by atraumatic removal of the pseudocapsule with minimal bipolar cauterization of small bleeders and an IVF-ET cycle (group A) and 39 control patients of similar age underwent an IVF-ET cycle for tubal factor infertility (group B).

INTERVENTION(S): Laparoscopic endometrioma cystectomy, IVF-ET cycle.

MAIN OUTCOME MEASURE(S): E(2) levels, number of gonadotropin ampoules, follicles, oocytes retrieved, number and quality of embryos transferred, and clinical pregnancy rate.

RESULT(S): There were no differences in all the parameters studied (E(2) levels, number of follicles, oocytes retrieved, number and quality of embryos transferred, and clinical pregnancy rate) except for the number of gonadotropin ampoules needed for ovarian hyperstimulation, which was significantly higher in group A than in group B.

CONCLUSION(S): Our results indicate that laparoscopic cystectomy for endometriomas is an appropriate treatment since it did not negatively affect the ovarian response for IVF-ET.

摘要

目的

评估既往因子宫内膜异位囊肿接受腹腔镜囊肿切除术的患者在体外受精-胚胎移植(IVF-ET)中的卵巢反应周期。

设计

对参与者和对照组进行前瞻性选择的回顾性研究。

地点

阿根廷布宜诺斯艾利斯妇科与生殖研究所。

患者

39例患者通过无创性去除假包膜并对小出血点进行最小化双极电凝,接受了卵巢子宫内膜异位囊肿手术及IVF-ET周期(A组),39例年龄相仿的对照患者因输卵管因素不孕接受IVF-ET周期(B组)。

干预措施

腹腔镜子宫内膜异位囊肿切除术、IVF-ET周期。

主要观察指标

雌二醇(E₂)水平、促性腺激素安瓿数量、卵泡数量、获取的卵母细胞数量、移植胚胎的数量和质量以及临床妊娠率。

结果

除卵巢超刺激所需促性腺激素安瓿数量外,所有研究参数(E₂水平、卵泡数量、获取的卵母细胞数量、移植胚胎的数量和质量以及临床妊娠率)均无差异,A组该指标显著高于B组。

结论

我们的结果表明,腹腔镜子宫内膜异位囊肿切除术是一种合适的治疗方法,因为它对IVF-ET的卵巢反应没有负面影响。

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