Dong Xiyuan, Liao Xiuhua, Wang Rui, Zhang Hanwang
Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology Wuhan, 430030, The People's Republic of China.
Int J Clin Exp Pathol. 2013 Aug 15;6(9):1911-8. eCollection 2013.
This retrospective cohort study was aimed to investigate the impact of endometriosis on the IVF/ICSI outcomes. A total of 1027 cycles of patients undergoing IVF/ICSI treatment in a reproductive medicine unit of academic hospital were enrolled. In the present study, 431 cycles of patients with endometriosis constituted the study group, including 152 cycles of patients with stage I-II endometriosis and 279 cycles of patients with stage III-IV endometriosis, while 596 cycles of patients with tubal factors infertility were considered as the control group. Ovarian stimulation parameters and IVF/ICSI outcomes were compared. Patients with stage I-II and stage III-IV endometriosis required higher dosage and longer duration of gonadotropins, but had lower day 3 high-quality embryos rate, when compared to patients with tubal infertility. In addition, the number of oocytes retrieved, the number of obtained embryos, the number of day 3 high-quality embryos, serum E2 level on the day of hCG, fertilization rate were lower in patients with stage III-IV endometriosis than those in tubal factors group. Except reduced implantation rate in stage III-IV endometriosis group, no differences were found in other pregnancy parameters. This study suggests that IVF/ICSI yielded similar pregnancy outcomes in patients with different stages of endometriosis and patients with tubal infertility. Therefore, IVF/ICSI can be considered as an effective approach for managing endometriosis-associated infertility.
这项回顾性队列研究旨在调查子宫内膜异位症对体外受精/卵胞浆内单精子注射(IVF/ICSI)结局的影响。在一家学术医院的生殖医学科,共有1027例接受IVF/ICSI治疗的患者周期被纳入研究。在本研究中,431例子宫内膜异位症患者周期构成研究组,其中包括152例I-II期子宫内膜异位症患者周期和279例III-IV期子宫内膜异位症患者周期,而596例输卵管因素不孕患者周期被视为对照组。比较了卵巢刺激参数和IVF/ICSI结局。与输卵管性不孕患者相比,I-II期和III-IV期子宫内膜异位症患者需要更高剂量和更长疗程的促性腺激素,但第三天优质胚胎率较低。此外,III-IV期子宫内膜异位症患者的获卵数、获得的胚胎数、第三天优质胚胎数、hCG日血清E2水平、受精率均低于输卵管因素组患者。除III-IV期子宫内膜异位症组着床率降低外,其他妊娠参数未发现差异。本研究表明,IVF/ICSI在不同分期的子宫内膜异位症患者和输卵管性不孕患者中产生相似的妊娠结局。因此,IVF/ICSI可被视为治疗子宫内膜异位症相关不孕症的有效方法。