Azumaguchi Atsushi, Henmi Hirofumi, Ohnishi Hirofumi, Endo Toshiaki, Saito Tsuyoshi
Sapporo Endometrium Research, Sapporo, Japan.
Department of Gynecology and Reproductive Endocrinology, KKR Sapporo Medical Center, Tonan Hospital, Sapporo, Japan.
J Obstet Gynaecol Res. 2017 Mar;43(3):523-529. doi: 10.1111/jog.13254. Epub 2017 Jan 26.
The aim of this study was to clarify the role of dilatation and curettage (D&C) performed for spontaneous or induced abortion in the etiology of endometrial thinning.
This was a retrospective and cross-sectional study of 310 infertile patients from January 2013 through December 2015. Endometrial thickness observed 5-7 days after ovulation in a natural menstrual cycle was correlated with the number of D&C noted in each patient's history.
Study 1 was an investigation of patients without D&C (group A: n = 232) and patients with D&C performed for spontaneous abortion (group B: n = 46). Study 2 was an investigation of patients in group A and patients with D&C performed for induced abortion (group C: n = 32). A significant negative correlation (P < 0.01) between endometrial thickness and number of D&C was observed in both studies. The mean endometrial thickness of the patients in group A was 10.9 ± 2.1 mm. The mean endometrial thickness of the patients in group B with one and ≥two D&C was 7.9 ± 2.3 and 6.9 ± 2.9 mm, respectively. The mean endometrial thickness of the patients in group C with one and ≥two D&C was 9.1 ± 2.3 and 7.8 ± 2.0 mm, respectively. There was a tendency toward gradual endometrial thinning following repeated procedures and the number of previous D&C was significantly associated with endometrial thinning (P < 0.001) in both studies.
D&C performed for spontaneous or induced abortion may play a causal role in endometrial thinning.
本研究旨在阐明因自然流产或人工流产行刮宫术（D&C）在子宫内膜变薄病因中的作用。
这是一项对2013年1月至2015年12月期间310例不孕患者的回顾性横断面研究。在自然月经周期中排卵后5 - 7天观察到的子宫内膜厚度与每位患者病历中记录的刮宫术次数相关。
研究1调查了未行刮宫术的患者（A组：n = 232）和因自然流产行刮宫术的患者（B组：n = 46）。研究2调查了A组患者和因人工流产行刮宫术的患者（C组：n = 32）。在两项研究中均观察到子宫内膜厚度与刮宫术次数之间存在显著负相关（P < 0.01）。A组患者的平均子宫内膜厚度为10.9±2.1毫米。B组中刮宫术1次和≥2次的患者平均子宫内膜厚度分别为7.9±2.3毫米和6.9±2.9毫米。C组中刮宫术1次和≥2次的患者平均子宫内膜厚度分别为9.1±2.3毫米和7.8±2.0毫米。在两项研究中，重复手术后均有子宫内膜逐渐变薄的趋势，且既往刮宫术次数与子宫内膜变薄显著相关（P < 0.001）。
因自然流产或人工流产行刮宫术可能在子宫内膜变薄中起因果作用。
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