子宫内膜异位症相关不孕：抗子宫内膜抗体阳性患者行宫腔内人工授精可提高生育能力。

Endometriosis-associated infertility: double intrauterine insemination improves fecundity in patients positive for antiendometrial antibodies.

机构信息

Department of Obstetrics and Gynecology, West Virginia University-Charleston Division, Charleston Area Medical Center, 800 Pennsylvania Avenue, Charleston, WV, USA.

出版信息

Am J Reprod Immunol. 2011 Aug;66(2):100-7. doi: 10.1111/j.1600-0897.2010.00973.x. Epub 2011 Jan 19.

DOI:10.1111/j.1600-0897.2010.00973.x

PMID:21244562

Abstract

PROBLEM

Prospective registry study evaluating effects of endometriosis (E) and serum antiendometrial antibodies (AEA) on fecundity in intrauterine insemination (IUI) cycles.

METHOD OF STUDY

AEA assays on 572 consecutive women receiving 969 single and 274 double IUI cycles. Logistic regression was utilized.

RESULTS

Fecundity was 11.5% (143/1243 cycles). Double IUI improved fecundity with significance achieved in certain study groups. Compared to the AEA- subgroup, all study groups except for the E+ AEA- group had significantly lower fecundity. Two study groups receiving double IUI had significantly increased fecundity, E- AEA+ (OR: 5.1, CI: 1.1-22.7, P=0.032) and E+ AEA+ (OR: 4.1, CI: 1.2-14.0, P=0.025) and significant predictors of pregnancy (E- AEA+, OR: 7.8, CI: 1.7-36.2, P=0.009 and E+ AEA+, OR: 4.2, CI: 1.2-15.1, P=0.026).

CONCLUSION

Double IUI improves fecundity in AEA+ patients. E-associated infertility is better diagnosed by the AEA assay than by surgery. Double IUI should be attempted prior to assisted reproductive technologies in AEA+ patients with normal fallopian tubes.

摘要

问题

一项前瞻性登记研究，评估子宫内膜异位症（E）和血清抗子宫内膜抗体（AEA）对宫内授精（IUI）周期生育能力的影响。

方法

对 572 例连续接受 969 次单 IUI 和 274 次双 IUI 周期的妇女进行 AEA 检测。采用逻辑回归。

结果

生育力为 11.5%（143/1243 个周期）。双 IUI 提高了生育力，在某些研究组中具有统计学意义。与 AEA-亚组相比，除 E+AEA-组外，所有研究组的生育力均显著降低。接受双 IUI 的两个研究组生育力显著增加，E- AEA+（OR：5.1，CI：1.1-22.7，P=0.032）和 E+ AEA+（OR：4.1，CI：1.2-14.0，P=0.025），且是妊娠的显著预测因子（E- AEA+，OR：7.8，CI：1.7-36.2，P=0.009 和 E+ AEA+，OR：4.2，CI：1.2-15.1，P=0.026）。