Ventolini Gary, Horowitz Gary M, Long Ronald
Department of Obstetrics and Gynecology, Wright State University, Ayton, Ohio 45409-2793, USA.
Reprod Biol Endocrinol. 2005 Apr 21;3:14. doi: 10.1186/1477-7827-3-14.
A long-term, follow-up study comparing mild and severe forms of endometriosis and their fecundability, on 28 women diagnosed with endometriosis in adolescence.
Twenty-eight patients were identified from a prospective cohort of 52 adolescents (ages 12 to 18 years) with operative diagnosis of endometriosis between July 1993 and December 1995. All patients presented with chronic pelvic pain unresponsive to conservative medical management. Diagnosis of pregnancy was made by sonographic identification of intrauterine pregnancy, positive serum human chorionic gonadotropin or pathological confirmation of products of conception. Patients were categorized as fertile or sub-fertile by having > 12 months of unprotected intercourse without conception. Follow-up was done for 8.6 years.
Staging of endometriosis was performed according to the American Society for Reproductive Medicine standards. Stage I = 14.3%; Stage II = 39.3%; Stage III = 42.8%; Stage IV = 3.6%. Fecundability rates in each stage were statistically significant: Stage I (75%), Stage II (55%), Stage III (25%), Stage IV (0%) (p < .05). Rates of spontaneous abortion were not statistically significant.
In our cohort, even at the earliest point in the natural life cycle of endometriosis there is an inverse relationship between stage of disease at diagnosis and fecundability.
一项长期随访研究，比较青春期诊断为子宫内膜异位症的28名女性中轻度和重度子宫内膜异位症及其受孕能力。
从1993年7月至1995年12月期间接受手术诊断为子宫内膜异位症的52名青少年（年龄12至18岁）的前瞻性队列中确定了28名患者。所有患者均表现为对保守药物治疗无反应的慢性盆腔疼痛。通过超声识别宫内妊娠、血清人绒毛膜促性腺激素阳性或对妊娠产物进行病理确认来诊断妊娠。通过有无保护性交超过12个月未受孕将患者分为可育或不育。随访8.6年。
根据美国生殖医学协会标准对子宫内膜异位症进行分期。I期 = 14.3%；II期 = 39.3%；III期 = 42.8%；IV期 = 3.6%。各期的受孕率具有统计学意义：I期（75%），II期（55%），III期（25%），IV期（0%）（p < 0.05）。自然流产率无统计学意义。
在我们的队列中，即使在子宫内膜异位症自然生命周期的最早阶段，诊断时疾病分期与受孕能力之间也存在反比关系。
