Cheewadhanaraks Sopon
Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkla, Thailand.
J Med Assoc Thai. 2004 Apr;87(4):361-6.
To study the prognosis for conception subsequent to a second conservative laparotomy for infertile patients with moderate and severe endometriosis, compared with the reproductive outcome of one cycle of in vitro fertilization and embryo transfer (IVF-ET).
From January 1990 to February 2000, 190 infertile patients had initial conservative laparotomy for pelvic endometriosis at a university hospital. All of these patients had moderate or severe endometriosis. After the failure of the initial operation to restore fertility, 32 patients requested the second operation while 24 patients underwent one cycle of IVF-ET. The cumulative pregnancy rate after the second operation was compared with the clinical pregnancy rate after one cycle of IVF-ET.
The cumulative pregnancy rate following the reoperation was 20.5% within 1 year with no additional increase in 2 and 3 years of follow up. The clinical pregnancy rate per stimulation of one cycle of IVF-ET was 12.5%. There was no statistically significant difference (P = 0.54).
Despite a trend toward a higher cumulative pregnancy rate following the second conservative laparotomy, there was no statistically significant difference, when compared with one cycle of IVF-ET in moderate and severe endometriosis-associated infertile patients who had not conceived after the initial operation.
研究中重度子宫内膜异位症不孕患者第二次保守性剖腹手术后的受孕预后，并与一个体外受精-胚胎移植（IVF-ET）周期的生殖结局进行比较。
1990年1月至2000年2月，190例不孕患者在一家大学医院接受了盆腔子宫内膜异位症的初次保守性剖腹手术。所有这些患者均患有中重度子宫内膜异位症。初次手术恢复生育功能失败后，32例患者要求进行第二次手术，24例患者接受了一个IVF-ET周期。将第二次手术后的累积妊娠率与一个IVF-ET周期后的临床妊娠率进行比较。
再次手术后1年内的累积妊娠率为20.5%，在2年和3年的随访中没有进一步增加。一个IVF-ET周期每次刺激的临床妊娠率为12.5%。没有统计学显著差异（P = 0.54）。
尽管第二次保守性剖腹手术后的累积妊娠率有升高趋势，但在初次手术后未受孕的中重度子宫内膜异位症相关不孕患者中，与一个IVF-ET周期相比，没有统计学显著差异。
