Department of Obstetrics and Gynecology, Hôpital Foch - Université de Paris Ouest (UVSQ), France; Dept Obstetrics and Gynecology- NYU Langone Health, New York, NY 10016, USA.
Department of Obstetrics and Gynecology, Hôpital Foch - Université de Paris Ouest (UVSQ), France.
Best Pract Res Clin Endocrinol Metab. 2019 Feb;33(1):47-59. doi: 10.1016/j.beem.2018.10.001. Epub 2018 Nov 3.
Endometriosis - a disease causing pain and infertility - is encountered in nearly 50% of infertile women. While medical treatment is effective on pain and recurrence of symptoms after surgical excision, it is of no help for treating infertility for which the only options considered are surgery and ART. Surgery enhances the chances of conceiving naturally during the 12-18 ensuing months irrespective of the stage of the disease. Surgery however is of no help when ART is considered, as it does not improve outcome and can only harm the ovarian response to stimulation. Today therefore, ART is commonly the primary option to be considered in women whose infertility is associated with endometriosis and whose ovarian reserve is compromised and/or who are over 35 years of age. When, ART is envisioned it is best to opt for a segmented ART approach with agonist trigger, freeze all and deferred embryo transfer.
子宫内膜异位症——一种导致疼痛和不孕的疾病——在近 50%的不孕女性中出现。虽然药物治疗对手术切除后疼痛和症状复发有效，但对于治疗不孕却没有帮助，唯一被考虑的方法是手术和辅助生殖技术（ART）。手术可以提高疾病各期不孕患者在接下来 12-18 个月内自然怀孕的机会。然而，当考虑进行 ART 时，手术则无济于事，因为它不会改善结果，只能损害卵巢对刺激的反应。因此，对于因子宫内膜异位症导致不孕且卵巢储备功能受损和/或年龄超过 35 岁的女性，ART 通常是首选治疗方法。当考虑进行 ART 时，最好选择采用激动剂触发的分段式 ART 方法，冷冻所有胚胎并推迟胚胎移植。
