Ferrero Simone, Scala Carolina, Tafi Emanuela, Racca Annalisa, Venturini Pier Luigi, Leone Roberti Maggiore Umberto
Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino - IST, Largo R. Benzi 10, 16132 Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy; Piazza della Vittoria 14, S.r.l., Italy.
Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino - IST, Largo R. Benzi 10, 16132 Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy.
Eur J Obstet Gynecol Reprod Biol. 2017 Jun;213:17-21. doi: 10.1016/j.ejogrb.2017.04.003. Epub 2017 Apr 2.
To assess the response to superovulation for in vitro fertilization (IVF) in patients with unilateral endometriomas with diameter ≥5cm and in the contralateral healthy ovary.
This retrospective analysis of a prospectively collected database included patients who underwent superovulation for IVF/ICSI cycles and had unoperated single unilateral endometrioma with diameter ≥5cm and healthy contralateral ovary. The primary outcome of the study was to compare the number of oocyte retrieved in the ovary with the endometrioma and the contralateral healthy ovary.
The total number of follicles was lower in ovaries with endometriomas (2.6±1.3) than in healthy ovaries (4.8±2.0; p<0.001). The number of codominant follicles and the total number of oocytes retrieved were lower in ovaries with endometriomas (1.5±0.9 and 2.0±1.2) than in the contralateral ovaries (3.7±1.5 and 4.2±1.7; p<0.001, respectively). The number of oocytes retrieved suitable for fertilization was lower in ovaries with endometriomas (1.5±1.1) than in the healthy ovaries (3.3±1.5; p<0.001). The total number of oocytes retrieved and the number of oocytes retrieved suitable for fertilization were lower in ovaries with endometriomas respectively in 21 (80.8%) and in 20 (76.9%) cases. The decreased responsiveness to ovarian superovulation was confirmed considering women with ultrasonographic diagnosis of deep infiltrating endometriosis. 30.8% of patients had positive HCG; the pregnancy rate was 23.1%.
The presence of large endometriomas (≥5cm) at time of IVF significantly decreases the number of oocyte retrieved compared with the contralateral healthy ovaries.
评估直径≥5cm的单侧卵巢子宫内膜异位囊肿患者及其对侧健康卵巢在体外受精（IVF）超排卵中的反应。
这项对前瞻性收集数据库的回顾性分析纳入了接受IVF/卵胞浆内单精子注射（ICSI）周期超排卵、患有未手术的直径≥5cm的单侧单发性卵巢子宫内膜异位囊肿且对侧卵巢健康的患者。该研究的主要结局是比较有子宫内膜异位囊肿的卵巢与对侧健康卵巢中获取的卵母细胞数量。
有子宫内膜异位囊肿的卵巢中的卵泡总数（2.6±1.3）低于健康卵巢（4.8±2.0；p<0.001）。有子宫内膜异位囊肿的卵巢中的优势卵泡数量和获取的卵母细胞总数（1.5±0.9和2.0±1.2）低于对侧卵巢（3.7±1.5和4.2±1.7；p分别<0.001）。有子宫内膜异位囊肿的卵巢中获取的适合受精的卵母细胞数量（1.5±1.1）低于健康卵巢（3.3±1.5；p<0.001）。有子宫内膜异位囊肿的卵巢中，分别有21例（80.8%）和20例（76.9%）获取的卵母细胞总数和适合受精的卵母细胞数量较低。考虑到经超声诊断为深部浸润性子宫内膜异位症的女性，卵巢超排卵反应性降低得到证实。30.8%的患者人绒毛膜促性腺激素（HCG）呈阳性；妊娠率为23. l%。
与对侧健康卵巢相比，IVF时存在大的子宫内膜异位囊肿（≥5cm）会显著减少获取的卵母细胞数量。
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