Check J H, Chase J S, Nowroozi K, Wu C
Department of Obstetrics and Gynecology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
Int J Fertil. 1987 Sep-Oct;32(5):366-8.
Several reports suggest that women with endometriosis have a higher risk of spontaneous abortions when left untreated; however, these studies did not control for the presence of possible luteal phase defects. This study was designed to document the frequency of spontaneous abortions in women with endometriosis and ovulation defects treated prophylactically with progesterone, compared with similar patients without endometriosis. All the women had late luteal phase endometrial biopsies dating perfectly normal. Our findings show an increase in the rate of spontaneous abortions (25.7%) in women with endometriosis as compared with the entire group (3.8%). However, when the result for the group with endometriosis is compared with the subgroup of patients at diagnostic laparoscopy not showing endometriosis, the results are similar (30%). We conclude that when properly matched groups are compared, there is no increased risk of spontaneous abortions in women with endometriosis. Since we perform laparoscopies only in women failing to conceive after a reasonable number of seemingly normal cycles, the apparently high incidence of abortions in this group may be secondary to other factors that not only may lengthen the time needed for conception but also increase the abortion risk after conception.
几份报告表明，子宫内膜异位症患者若不接受治疗，自然流产的风险会更高；然而，这些研究并未对可能存在的黄体期缺陷进行控制。本研究旨在记录接受黄体酮预防性治疗的子宫内膜异位症合并排卵缺陷的女性与无子宫内膜异位症的类似患者相比，自然流产的发生率。所有女性的黄体晚期子宫内膜活检结果均完全正常。我们的研究结果显示，与整个研究组（3.8%）相比，子宫内膜异位症患者的自然流产率有所上升（25.7%）。然而，当将子宫内膜异位症组的结果与诊断性腹腔镜检查时未发现子宫内膜异位症的患者亚组进行比较时，结果相似（30%）。我们得出结论，当对匹配良好的组进行比较时，子宫内膜异位症女性的自然流产风险并未增加。由于我们仅对经过合理数量看似正常的周期仍未受孕的女性进行腹腔镜检查，该组中明显较高的流产发生率可能继发于其他因素，这些因素不仅可能延长受孕所需时间，还会增加受孕后的流产风险。
