Nakagawa Koji, Ohgi Shirei, Kojima Rieko, Sugawara Kana, Ito Megumu, Horikawa Takashi, Irahara Minoru, Saito Hidekazu
Division of Reproductive Medicine, Department of Perinatal Medicine and Maternal Care, National Center for Child Health and Development, Tokyo, Japan.
J Obstet Gynaecol Res. 2007 Oct;33(5):671-6. doi: 10.1111/j.1447-0756.2007.00630.x.
To clarify the effect of laparoscopic cystectomy for ovarian endometrioma in infertility patients, the pregnancy outcome was evaluated.
This was a retrospective study. From August 2002 to February 2006, 33 infertility patients with ovarian endometrioma underwent laparoscopic cystectomy at our center. According to the laparoscopic findings 33 were divided into two groups; 10 were evaluated as the patients who need assisted reproductive technologies (ART) treatment (IVF subgroup) and 23 were evaluated as the patients who do not need ART treatment but conventional infertility treatment (non-IVF subgroup). During the same period, 70 patients who were age-matched and received ART treatment without laparoscopy were defined as control (control group). Following up to 12 months after laparoscopy, the cumulative pregnancy rate in the non-IVF subgroup was calculated.
The patients age, duration of infertility and size of endometrioma were equal in the IVF and the non-IVF subgroups. The revised-American Society of Reproductive Medicine (r-ASRM) score in the IVF subgroup was significantly higher than that in the non-IVF group (P < 0.05). The pregnancy rates after laparoscopic cystectomy in IVF and non-IVF subgroups were 50.0% and 60.9%, respectively. These rates in the IVF and the non-IVF groups were slightly higher than that in control group (41.4%), but these differences were not significant. The cumulative pregnancy rate in the non-IVF group reached 52.2%, 12 months after laparoscopic surgery.
Laparoscopic surgery should be performed prior to ART treatment not only for making a decision about the treatment course but also for establishing a good pelvic condition to induce a pregnancy during ART treatment in infertility treatment with ovarian endometrioma.
为阐明腹腔镜下卵巢子宫内膜异位囊肿切除术对不孕患者的影响，对妊娠结局进行评估。
这是一项回顾性研究。2002年8月至2006年2月，33例患有卵巢子宫内膜异位囊肿的不孕患者在本中心接受了腹腔镜囊肿切除术。根据腹腔镜检查结果，33例患者被分为两组；10例被评估为需要辅助生殖技术（ART）治疗的患者（IVF亚组），23例被评估为不需要ART治疗但需要常规不孕治疗的患者（非IVF亚组）。同期，70例年龄匹配且未接受腹腔镜检查而接受ART治疗的患者被定义为对照组（对照组）。腹腔镜检查后随访12个月，计算非IVF亚组的累积妊娠率。
IVF亚组和非IVF亚组患者的年龄、不孕持续时间和子宫内膜异位囊肿大小相等。IVF亚组的美国生殖医学学会修订版（r-ASRM）评分显著高于非IVF组（P<0.05）。IVF亚组和非IVF亚组腹腔镜囊肿切除术后的妊娠率分别为50.0%和60.9%。IVF组和非IVF组的这些妊娠率略高于对照组（41.4%），但这些差异无统计学意义。腹腔镜手术后12个月，非IVF组的累积妊娠率达到52.2%。
在卵巢子宫内膜异位症不孕治疗中，腹腔镜手术应在ART治疗之前进行，这不仅有助于决定治疗方案，还能为ART治疗期间诱导妊娠建立良好的盆腔条件。
