Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China.
Sci Rep. 2017 Sep 20;7(1):11927. doi: 10.1038/s41598-017-12151-7.
This study investigated the use of medroxyprogesterone acetate (MPA) or a short protocol for controlled ovarian hyperstimulation (COH) in patients with advanced endometriosis who have normal ovarian function, and to compare cycle characteristics and pregnancy outcomes after frozen-thawed embryo transfer (FET). This was a retrospective case-control study of 244 patients with advanced endometriosis undering COH. The patients were allocated to three groups: the surgery group with MPA COH (62 patients, 71 IVF/ICSI cycles, 78 FET cycles); the aspiration group with MPA COH (85 patients had ovarian "chocolate" cysts (>3 cm) aspirated, 90 IVF/ICSI cycles, 76 FET cycles); and the short protocol group (97 patients, 101 IVF/ICSI cycles, 51 FET cycles). The results showed that higher rates of mature oocyte, D3 high quality embryo, hMG dose were observed in the two study groups using MPA compared with the short protocol. The number of >10-14 mm follicles on the trigger day, D3 top-quality embryos, viable embryos, rates of cancellation, fertilization, implantation, pregnancy outcomes were similar among the three groups. The oocytes, embryos, and pregnancy outcomes were not influenced by endometrioma surgery or presence of endometrioma. MPA COH could be effective for women with ovarian advanced endometriosis who had normal ovarian function.
本研究探讨了醋酸甲羟孕酮（MPA）或短方案在卵巢功能正常的晚期子宫内膜异位症患者控制性卵巢超刺激（COH）中的应用，并比较了冻融胚胎移植（FET）后的周期特征和妊娠结局。这是一项回顾性病例对照研究，纳入了 244 例接受 COH 的晚期子宫内膜异位症患者。患者分为三组：MPA COH 手术组（62 例，71 个 IVF/ICSI 周期，78 个 FET 周期）；MPA COH 抽吸组（85 例卵巢“巧克力”囊肿（>3cm）抽吸，90 个 IVF/ICSI 周期，76 个 FET 周期）；以及短方案组（97 例，101 个 IVF/ICSI 周期，51 个 FET 周期）。结果显示，与短方案相比，使用 MPA 的两组患者的成熟卵母细胞、D3 优质胚胎和 hMG 剂量更高。扳机日>10-14mm 卵泡数、D3 优质胚胎数、可利用胚胎数、取消率、受精率、着床率、妊娠结局在三组间相似。卵巢子宫内膜异位症手术或存在子宫内膜异位症囊肿不影响卵母细胞、胚胎和妊娠结局。MPA COH 可有效用于卵巢功能正常的晚期子宫内膜异位症患者。
