Pop-Trajkovic Sonja, Kopitovic Vesna, Popovic Jasmina, Antic Vladimir, Radovic Dragana, Zivadinovic Radomir
Clinic for Gynecology & Obstetrics, Clinical Center of Nis, Serbia.
Indian J Med Res. 2014 Sep;140(3):387-91.
BACKGROUND & OBJECTIVES: Women with endometriosis often need in vitro fertilization (IVF) to concieve. There are conflicting data on the results of IVF in patients with endometriosis. This study was undertaken to elucidate the influence of endometriosis on IVF outcome to give the best counselling for infertile patient with this problem.
The outcome measures in 78 patients with surgically confirmed endometriosis were compared with 157 patients with tubal factor infertility, all of whom have undergone IVF. The groups were matched for age and follicle stimulating hormone (FSH) levels. Outcome measures included number of follicles, number of oocytes, peak oestradiol (E2) concentrations and mean number of ampoules of gonadotropins. Cumulative pregnancy, miscarriage and live birth rates were calculated in both the groups.
Higher cancelation rates, higher total gonadotropin requirements, lower peak E2 levels and lower oocyte yield were found in women with endometriosis and previous surgery compared with those with tubal factor infertility. However, no differences were found in fertilization, implantation, pregnancy, miscarriage, multiple births and delivery rates between the endometriosis and tubal factor infertility groups.
INTERPRETATION & CONCLUSIONS: The present findings showed that women with endometriosis and previous surgery responded less well to gonadotropins during ovarian stimulation and hence the cost of treatment to achieve pregnancy was higher in this group compared with those with tubal factor infertility. However, the outcome of IVF treatment in patients with endometriosis was as good as in women with tubal factor infertility.
患有子宫内膜异位症的女性常常需要通过体外受精（IVF）来受孕。关于子宫内膜异位症患者体外受精的结果，存在相互矛盾的数据。开展本研究以阐明子宫内膜异位症对体外受精结局的影响，从而为患有该疾病的不孕患者提供最佳咨询。
将78例经手术确诊为子宫内膜异位症的患者的结局指标与157例输卵管因素不孕症患者进行比较，所有这些患者均接受了体外受精。两组在年龄和促卵泡激素（FSH）水平上进行了匹配。结局指标包括卵泡数量、卵母细胞数量、雌二醇（E2）峰值浓度以及促性腺激素安瓿的平均数量。计算两组的累积妊娠率、流产率和活产率。
与输卵管因素不孕症患者相比，有子宫内膜异位症且既往接受过手术的女性取消率更高、促性腺激素总需求量更高、E2峰值水平更低且卵母细胞产量更低。然而，子宫内膜异位症组和输卵管因素不孕症组在受精率、着床率、妊娠率、流产率、多胎出生率和分娩率方面未发现差异。
目前的研究结果表明，有子宫内膜异位症且既往接受过手术的女性在卵巢刺激过程中对促性腺激素的反应较差，因此与输卵管因素不孕症患者相比，该组实现妊娠的治疗成本更高。然而，子宫内膜异位症患者的体外受精治疗结局与输卵管因素不孕症女性的结局一样好。
