Department of Obstetrics and Gynecology, Affiliated to the Sackler School of Medicine, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv University, 6 Weizmann Street, 6423906, Tel Aviv, Israel.
Arch Gynecol Obstet. 2019 Sep;300(3):763-769. doi: 10.1007/s00404-019-05230-9. Epub 2019 Jul 5.
To determine the impact of pelvic inflammation caused by tubo-ovarian abscess (TOA) on ovarian response to stimulation.
This retrospective longitudinal cohort analysis that was carried out in a tertiary university-affiliated medical center included 15 women with TOA during in vitro fertilization (IVF) cycles. The ovarian response to stimulation and the pregnancy rate were compared in two subsequent cycles, the initial IVF cycle that was complicated by TOA after oocyte retrieval (first treatment cycle) and the following IVF treatment (second treatment cycle) that occurred within a period of a year from the first cycle.
The mean number of retrieved oocytes was significantly higher in the first IVF cycle compared to the second cycle (8.1 ± 3.2 vs. 5.4 ± 2.5, P = .003], corresponding to a 30% reduction in ovarian response to gonadotropin stimulation. Fertilization rates were significantly lower in the second cycle (4.1 ± 2.9 vs. 2.9 ± 1.7, P = .015). Twelve women (80%) reached embryo transfer in the first cycle compared to 14 women (93.3%) in the second cycle. The mean number of transferred embryos was similar between the two cycles. There were no clinical pregnancies following the first cycle, and only one patient (6.6%) had a clinical pregnancy in the second treatment cycle.
TOA following fertility treatment has a detrimental effect on ovarian function. The pregnancy rate in the immediate period following TOA is poor. Current data for recommending the deferral of fertility treatment following a TOA episode are insufficient, calling for more studies to address these issues.
确定由输卵管卵巢脓肿（TOA）引起的盆腔炎对卵巢刺激反应的影响。
这是一项在三级大学附属医院进行的回顾性纵向队列分析，纳入了 15 名在体外受精（IVF）周期中发生 TOA 的女性。比较了取卵后（第一次治疗周期）发生 TOA 的初始 IVF 周期和随后一年内进行的后续 IVF 治疗（第二次治疗周期）中卵巢对刺激的反应和妊娠率。
与第二次周期相比，第一次 IVF 周期中取回的卵母细胞数量明显更高（8.1±3.2 对 5.4±2.5，P=0.003]，这对应于卵巢对促性腺激素刺激反应的 30%降低。第二次周期的受精率明显较低（4.1±2.9 对 2.9±1.7，P=0.015）。第一次周期有 12 名女性（80%）达到胚胎移植，而第二次周期有 14 名女性（93.3%）达到胚胎移植。两个周期的平均胚胎移植数量相似。第一次周期没有临床妊娠，第二次治疗周期仅有 1 名患者（6.6%）有临床妊娠。
生育治疗后发生的 TOA 对卵巢功能有不良影响。TOA 后即刻的妊娠率较差。目前关于推荐在发生 TOA 后推迟生育治疗的推荐数据不足，需要更多的研究来解决这些问题。
