Fujimoto Akihisa, Ichinose Mari, Harada Miyuki, Hirata Tetsuya, Osuga Yutaka, Fujii Tomoyuki
Department of Obstetrics and Gynecology, Sanraku Hospital, 2-5, Kanda-Surugadai, Chiyoda-ku, Tokyo, Japan, 101-8326,
J Assist Reprod Genet. 2014 Sep;31(9):1189-94. doi: 10.1007/s10815-014-0297-x. Epub 2014 Aug 10.
To elucidate the problems in infertility treatment for women after conservative therapy for endometrial cancer (EC) or atypical complex endometrial hyperplasia (ACEH).
The clinical outcomes of 21 patients who underwent assisted reproductive technology after conservative therapy (group A) and 42 control women (group B) were retrospectively analyzed.
There was no significant difference in the number of retrieved oocytes, fertilization rate or the number of transferred embryos between the two groups. Women in group A had a significantly thinner endometrium and a reduced implantation rate compared to those for women in group B. There was no significant difference in the cumulative clinical pregnancy and delivery rates between group A and B. The patients in group A required significantly more embryos for achieving a live-birth.
Our results indicate that a thin endometrium after repeated curettage may have a negative effect on endometrial receptivity of patients after conservative treatment for EC/ACEH. Clinicians should reconsider their present protocols and make efforts to minimize the damage to normal endometrium.
阐明子宫内膜癌（EC）或非典型复杂性子宫内膜增生（ACEH）保守治疗后女性不孕症治疗中的问题。
回顾性分析21例保守治疗后接受辅助生殖技术的患者（A组）和42例对照女性（B组）的临床结局。
两组之间的获卵数、受精率或移植胚胎数无显著差异。与B组女性相比，A组女性的子宫内膜明显更薄，着床率降低。A组和B组之间的累积临床妊娠率和分娩率无显著差异。A组患者需要显著更多的胚胎才能实现活产。
我们的结果表明，反复刮宫后子宫内膜变薄可能对EC/ACEH保守治疗后患者的子宫内膜容受性产生负面影响。临床医生应重新考虑当前方案，并努力将对正常子宫内膜的损伤降至最低。
