卵巢子宫内膜异位囊肿手术后严重卵巢损伤的发生率。
Rate of severe ovarian damage following surgery for endometriomas.
机构信息
Infertility Unit, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via M Fanti 6, 20122 Milan, Italy.
出版信息
Hum Reprod. 2010 Mar;25(3):678-82. doi: 10.1093/humrep/dep464. Epub 2010 Jan 17.
BACKGROUND
There is growing and consistent evidence showing that ovarian reserve is affected following surgical excision of ovarian endometriomas. Of particular concern is the risk of severe ovarian damage leading to unresponsiveness to ovarian hyperstimulation. In this study, we aimed to determine the rate of this complication.
METHODS
Ninety-three women underwent surgery for monolateral endometriomas were recruited. Patients who underwent IVF were selected and, in all cases, follicular growth was monitored by serial transvaginal ultrasonography. The main outcome measure was the rate of ovaries remaining silent when stimulated after surgery for endometriomas.
RESULTS
Absence of follicular growth was observed in 12 operated ovaries although this event never occurred in the contralateral gonad (P < 0.001). The frequency (95% confidence interval) of severe ovarian damage following surgery was 13% (7-21%).
CONCLUSIONS
Severe ovarian damage, occurring in gonads operated on for ovarian endometriomas, is not a rare event.
背景
越来越多的证据表明，卵巢子宫内膜异位囊肿的手术切除会影响卵巢储备功能。特别令人担忧的是，严重的卵巢损伤会导致对卵巢过度刺激反应不良的风险。在这项研究中，我们旨在确定这种并发症的发生率。
方法
招募了 93 名接受单侧子宫内膜异位囊肿手术的女性。选择接受体外受精的患者，在所有情况下，通过经阴道超声连续监测卵泡生长。主要观察指标是手术后卵巢刺激时卵巢沉默的发生率。
结果
尽管这种情况从未在对侧卵巢中发生（P<0.001），但在 12 个手术卵巢中观察到卵泡生长缺失。手术后严重卵巢损伤的频率（95%置信区间）为 13%（7-21%）。
结论
在因卵巢子宫内膜异位囊肿而接受手术的卵巢中发生的严重卵巢损伤并非罕见事件。
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