Nakagawa Koji, Nishi Yayoi, Sugiyama Rie, Kuribayashi Yasushi, Akira Shigeo, Sugiyama Rikikazu, Inoue Masto
Division of Reproductive Medicine, Sugiyama Clinic, Tokyo, Japan.
J Obstet Gynaecol Res. 2013 May;39(5):979-84. doi: 10.1111/jog.12033. Epub 2013 Apr 3.
The aim of this study was to observe the insides of the fallopian tubes of patients with unilateral or bilateral endometriomas by using salpingoscopy and evaluate the inner cavity of the fallopian tubes according to our original scoring system.
From April 2008 through December 2010, patients with unilateral or bilateral endometriomas were recruited (n = 157, endometrioma group). All patients underwent laparoscopic ovarian cystectomy and salpingoscopy. Using salpingoscopy, we observed the tubal lumen and calculated a fallopian tube score (F score) paying attention to the following six results: adhesions, loss of mucosal folds, rounded edges of mucosal folds, debris, foreign bodies, and abnormal vessels. The F scores were compared with those of the unexplained infertility patients who received those same procedures during the same period (n = 235; control group).
Slightly more than three-quarters (75.9%) of the patients in the endometrioma group received F scores of 0, and this percentage was significantly higher than that for the control group (139/235 = 59.1%, P < 0.05). The pregnancy rate after conventional treatment for the endometrioma group was 21.7%, and all pregnant patients had achieved an F score of less than 2.
It is highly possible that infertility patients with ovarian endometriomas are more likely to have intact fallopian tubes, by comparison with infertility patients who do not have ovarian endometriomas.
本研究旨在通过输卵管镜观察单侧或双侧卵巢子宫内膜异位囊肿患者的输卵管内部情况，并根据我们原有的评分系统评估输卵管内腔。
从2008年4月至2010年12月，招募单侧或双侧卵巢子宫内膜异位囊肿患者（n = 157，子宫内膜异位囊肿组）。所有患者均接受腹腔镜卵巢囊肿切除术和输卵管镜检查。通过输卵管镜，我们观察输卵管管腔，并计算输卵管评分（F评分），重点关注以下六个结果：粘连、黏膜皱襞缺失、黏膜皱襞边缘圆润、碎片、异物和异常血管。将F评分与同期接受相同手术的不明原因不孕症患者（n = 235；对照组）的评分进行比较。
子宫内膜异位囊肿组略超过四分之三（75.9%）的患者F评分为0，该百分比显著高于对照组（139/235 = 59.1%，P < 0.05）。子宫内膜异位囊肿组常规治疗后的妊娠率为21.7%，所有妊娠患者的F评分均小于2。
与没有卵巢子宫内膜异位囊肿的不孕症患者相比，患有卵巢子宫内膜异位囊肿的不孕症患者的输卵管更有可能保持完好。
