Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Haidian district, North garden road, No 49, Beijing, People's Republic of China.
National Clinical Research Center for Obstetrics and Gynecology, Beijing, 100191, China.
Reprod Biol Endocrinol. 2019 Feb 12;17(1):21. doi: 10.1186/s12958-019-0463-1.
Endometriosis is thought to affect the effectiveness of ART by an increased risk of miscarriage. We aimed to investigate the impact of endometriosis in women achieving singleton pregnancies through IVF fresh cycles and risk of miscarriage.
This retrospective cohort study included all women undergoing a first IVF cycle and achieving singleton pregnancies after fresh embryo transfer in a tertiary university hospital reproductive medical center between January 2008 and June 2016. Women with endometriosis were compared with women with no endometriosis. Women in the endometriosis group were all with a history of laparoscopy or laparotomy for endometriosis and/or with ovarian endometrioma. The control group was matched 1:2 according to age and study period.
Among the cohort, we identified 1006 women with endometriosis as study group and 2012 unaffected women matched in a 1:2 ratios as control group. The miscarriage rate between women with and without endometriosis was similar (22.4 and 20.1%, P = 0.085). The odds ratio after adjusting for the risk factors for miscarriage was 1.14 (95% confidence interval 0.95-1.37). In the study group, the women with and without endometrioma did not show a significant risk of miscarriage, (19.8 and 23.8%, P = 0.152, OR 0.79, 95% CI 0.58-1.09). The miscarriage rate in women with endometrioma ≥30 mm (37.3 ± 7.1 mm) and < 30 mm (19.3 ± 5.5 mm) was not significantly different, (24.7 and 18.5%, P = 0.229, OR 1.44, 95% CI 0.79-2.63). After adjustment for risk factors for miscarriage, the presence of endometrioma and the size of endometrioma, regression model confirmed no significant increase for the risk of miscarriage in the subgroup analyses.
The risk of miscarriage did not statistically increase in women with endometriosis who achieved pregnancy through IVF fresh cycles.
内异症被认为会增加流产风险，从而影响 ART 的有效性。我们旨在研究内异症对通过体外受精新鲜周期获得单胎妊娠的妇女的影响及其流产风险。
本回顾性队列研究纳入了 2008 年 1 月至 2016 年 6 月期间在一家三级大学医院生殖医学中心接受首次体外受精周期并在新鲜胚胎移植后获得单胎妊娠的所有妇女。将内异症妇女与无内异症妇女进行比较。内异症组的所有妇女均有腹腔镜或剖腹手术治疗内异症和/或卵巢子宫内膜异位症的病史。对照组按年龄和研究期间 1:2 匹配。
在该队列中，我们确定了 1006 名内异症妇女作为研究组，2012 名未受影响的妇女按 1:2 的比例作为对照组。有和无内异症妇女的流产率相似（22.4%和 20.1%，P=0.085）。调整流产危险因素后，比值比为 1.14（95%置信区间 0.95-1.37）。在研究组中，有和无卵巢子宫内膜异位症的妇女流产风险无显著差异（19.8%和 23.8%，P=0.152，OR 0.79，95%CI 0.58-1.09）。卵巢子宫内膜异位症≥30mm（37.3±7.1mm）和＜30mm（19.3±5.5mm）的妇女流产率无显著差异（24.7%和 18.5%，P=0.229，OR 1.44，95%CI 0.79-2.63）。调整流产危险因素后，亚组分析证实，存在卵巢子宫内膜异位症和卵巢子宫内膜异位症的大小对流产风险无显著增加。
通过体外受精新鲜周期获得妊娠的内异症妇女的流产风险没有统计学上的增加。
