Gupta Sajal, Agarwal Ashok, Agarwal Rishi, Loret de Mola J Ricardo
Reproductive Research Centre, Glickman Urological Institute and the Department of Obstetrics-Gynecology, Cleveland Clinic Foundation, Cleveland, OH, USA.
Reprod Biomed Online. 2006 Sep;13(3):349-60. doi: 10.1016/s1472-6483(10)61439-3.
The effects of ovarian endometrioma on fertility outcomes with IVF and embryo transfer have been causally related to poor outcomes. The objective of this meta-analysis was to evaluate the ovarian reserve and ovarian responsiveness to ovarian stimulation and assisted reproduction outcomes in patients with ovarian endometrioma. The odds for clinical pregnancy were not affected significantly in patients with ovarian endometrioma compared with controls, with an overall odds ratio of 1.07 from three studies [95% CI: (0.63, 1.81), P = 0.79]. The overall pregnancy rate was similar with an estimated odds ratio of 1.17 [95% CI: (0.85, 1.60), P = 0.34]. Decreased ovarian responsiveness to ovarian stimulation in patients with ovarian endometrioma may be due to a reduced number of follicles in these patients compared with controls (P = 0.002). Prospective randomized controlled trials are needed to assess whether surgical treatment versus no surgical treatment improves pregnancy outcomes in patients with ovarian endometrioma undergoing assisted reproduction cycles.
卵巢子宫内膜异位囊肿对体外受精和胚胎移植的生育结局有不良影响。本荟萃分析的目的是评估卵巢子宫内膜异位囊肿患者的卵巢储备、卵巢对卵巢刺激的反应性以及辅助生殖结局。与对照组相比，卵巢子宫内膜异位囊肿患者临床妊娠的几率未受到显著影响，三项研究的总体优势比为1.07 [95%可信区间：(0.63, 1.81)，P = 0.79]。总体妊娠率相似，估计优势比为1.17 [95%可信区间：(0.85, 1.60)，P = 0.34]。卵巢子宫内膜异位囊肿患者对卵巢刺激的反应性降低，可能是因为与对照组相比，这些患者的卵泡数量减少(P = 0.002)。需要进行前瞻性随机对照试验，以评估手术治疗与非手术治疗相比，是否能改善接受辅助生殖周期的卵巢子宫内膜异位囊肿患者的妊娠结局。
