Section for Reproductive Medicine, Department of Gynaecology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
Fertil Steril. 2012 Apr;97(4):912-8. doi: 10.1016/j.fertnstert.2012.01.112. Epub 2012 Feb 15.
To assess success rates of IVF and intracytoplasmic sperm injection in women with various stages of endometriosis.
Retrospective cohort study.
Reproductive medicine unit in a university hospital.
PATIENT(S): Infertile women (n = 2,245) with various stages of endometriosis or tubal factor infertility.
INTERVENTION(S): IVF or intracytoplasmic sperm injection.
MAIN OUTCOME MEASURE(S): Dose of FSH, number of oocytes retrieved, fertilization rate, implantation rate, pregnancy rate (PR), live birth/ongoing PR.
RESULT(S): Women with endometriosis had similar pregnancy and live birth/ongoing PR as did women with tubal factor infertility, but the American Society for Reproductive Medicine (ASRM) stage I and II endometriosis patients had a lower fertilization rate, and stage III and IV patients required more FSH and had fewer oocytes retrieved. Splitting the stage III and IV groups into patients with and without endometriomas showed that the endometrioma group required more FSH and had a significantly lower pregnancy and live birth/ongoing PR.
CONCLUSION(S): With the exception of patients with endometrioma, infertile women with various stages of endometriosis have the same success rates with IVF and intracytoplasmic sperm injection as patients with tubal factor. This contrasts with the systematic review on which the European Society of Human Reproduction and Embryology bases its recommendations.
评估不同期别子宫内膜异位症患者行体外受精(IVF)和卵胞浆内单精子注射(ICSI)的妊娠结局。
回顾性队列研究。
大学医院生殖医学中心。
各种期别子宫内膜异位症或输卵管因素不孕的不孕女性(n=2245)。
IVF 或 ICSI。
促卵泡激素(FSH)剂量、获卵数、受精率、种植率、妊娠率(PR)、活产/持续 PR。
与输卵管因素不孕患者相比,子宫内膜异位症患者的妊娠结局和活产/持续 PR 相似,但美国生殖医学学会(ASRM)Ⅰ期和Ⅱ期子宫内膜异位症患者的受精率较低,Ⅲ期和Ⅳ期患者需要更多的 FSH 且获卵数较少。将Ⅲ期和Ⅳ期患者分为有无子宫内膜异位囊肿(内异囊肿)两组后发现,内异囊肿组需要更多的 FSH,且妊娠结局和活产/持续 PR 显著较低。
除了内异囊肿患者外,各种期别子宫内膜异位症的不孕女性行 IVF 和 ICSI 的妊娠结局与输卵管因素不孕患者相同。这与欧洲人类生殖与胚胎学会(ESHRE)基于系统评价提出的推荐意见相悖。