Al-Fadhli Raedah, Kelly Simon M, Tulandi Togas, Lin Tan Seang
Department of Obstetrics and Gynecology, McGill University, Montreal QC.
J Obstet Gynaecol Can. 2006 Oct;28(10):888-891. doi: 10.1016/S1701-2163(16)32285-X.
This study was undertaken to evaluate the effects of different stages of endometriosis on the outcome of treatment in an in vitro fertilization (IVF) program.
This was a retrospective, matched case-control study in an academic tertiary referral centre. The study group consisted of 87 women with laparoscopically diagnosed endometriosis, and the control group consisted of 87 age-matched women undergoing IVF for different reasons. The primary outcomes were duration of stimulation, total gonadotropin dose requirement, peak serum estradiol level, total number of oocytes retrieved, fertilization rate, embryo quality, implantation rate, and clinical pregnancy rate. The effect of obliteration of the cul-de-sac by endometriosis was also evaluated.
Women with endometriosis required significantly higher gonadotropin doses than women in the control group (P < 0.01). The fertilization rate was significantly lower for women with endometriosis (P < 0.05), although there was no difference in embryo quality or in the number of embryos transferred. In patients with an obliterated cul-de-sac, fewer oocytes were retrieved than in patients in the control group (P < 0.01).
The presence of endometriosis, including stages III and IV, does not affect IVF outcome. However, women with endometriosis require more gonadotropin stimulation than those with no endometriosis. Women with an obliterated cul-de-sac have fewer oocytes retrieved than women without obliteration.
本研究旨在评估子宫内膜异位症不同阶段对体外受精（IVF）治疗结局的影响。
这是一项在学术性三级转诊中心进行的回顾性匹配病例对照研究。研究组由87例经腹腔镜诊断为子宫内膜异位症的女性组成，对照组由87例因不同原因接受IVF治疗的年龄匹配女性组成。主要结局指标包括刺激时间、总促性腺激素剂量需求、血清雌二醇峰值水平、获卵总数、受精率、胚胎质量、着床率和临床妊娠率。还评估了子宫内膜异位症导致的直肠子宫陷凹闭塞的影响。
子宫内膜异位症患者所需的促性腺激素剂量显著高于对照组女性（P < 0.01）。子宫内膜异位症患者的受精率显著较低（P < 0.05），尽管胚胎质量或移植胚胎数量没有差异。直肠子宫陷凹闭塞的患者比对照组患者获卵数更少（P < 0.01）。
子宫内膜异位症（包括III期和IV期）的存在不影响IVF结局。然而，子宫内膜异位症患者比无子宫内膜异位症的患者需要更多的促性腺激素刺激。直肠子宫陷凹闭塞的女性比未闭塞的女性获卵数更少。
