Caran Juliana, Genro Vanessa Krebs, Souza Carlos Augusto Bastos de, Cunha-Filho João Sabino
Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Department of Obstetrics and Gynecology, Centro de Reprodução Humana Insemine, Porto Alegre, RS, Brazil.
Rev Bras Ginecol Obstet. 2021 Jan;43(1):28-34. doi: 10.1055/s-0040-1721855. Epub 2021 Jan 29.
To determine embryo quality (mean graduated embryo score [GES]) in infertile patients with endometriosis undergoing in vitro fertilization with embryo transfer (IVF-ET) compared with infertile patients without endometriosis.
A case-control study was performed comparing 706 embryos (162 patients) divided into 2 groups: 472 embryos derived from patients without endometriosis ( = 109, infertile patients with tubal infertility) and 234 embryos from patients in the study group ( = 53, infertile patients with peritoneal endometriosis). All patients were subjected to IVF using an oestradiol-antagonist-recombinant follicle-stimulating hormone (FSH) protocol for ovarian stimulation. The mean GES was performed to evaluate all embryos at 3 points in time: 16 to 18 hours, 25 to 27 hours, and 64 to 67 hours. Embryo evaluation was performed according to the following parameters: fragmentation, nucleolar alignment, polar body apposition, blastomere number/morphology, and symmetry. The primary outcome measure was the mean GES score. We also compared fertilization, implantation, and pregnancy rates.
Although the number of embryos transferred was greater in patients with endometriosis than in the control group (2.38 ± 0.66 versus 2.15 ± 0.54; = 0.001), the mean GES was similar in both groups (71 ± 19.8 versus 71.9 ± 23.5; = 0.881). Likewise, the fertilization rate was similar in all groups, being 61% in patients with endometriosis and 59% in the control group ( = 0.511). No significant differences were observed in the implantation (21% versus 22%; [ = 0.989]) and pregnancy rates (26.4% versus 28.4%; = 0.989).
Embryo quality measured by the mean GES was not influenced by peritoneal endometriosis. Likewise, the evaluated reproductive outcomes were similar between infertile patients with and without endometriosis.
与无子宫内膜异位症的不孕患者相比，确定接受体外受精胚胎移植（IVF-ET）的子宫内膜异位症不孕患者的胚胎质量（平均分级胚胎评分[GES]）。
进行一项病例对照研究，将706个胚胎（162例患者）分为两组：472个胚胎来自无子宫内膜异位症的患者（n = 109，输卵管性不孕的不孕患者），234个胚胎来自研究组患者（n = 53，腹膜子宫内膜异位症的不孕患者）。所有患者均采用雌二醇拮抗剂-重组促卵泡激素（FSH）方案进行卵巢刺激的IVF。在三个时间点对所有胚胎进行平均GES评估：16至18小时、25至27小时和64至67小时。根据以下参数进行胚胎评估：碎片、核仁排列、极体附着、卵裂球数量/形态和对称性。主要结局指标是平均GES评分。我们还比较了受精率、着床率和妊娠率。
尽管子宫内膜异位症患者移植的胚胎数量多于对照组（2.38±0.66对2.15±0.54；P = 0.001），但两组的平均GES相似（71±19.8对71.9±23.5；P = 0.881）。同样，所有组的受精率相似，子宫内膜异位症患者为61%，对照组为59%（P = 0.511）。着床率（21%对22%；[P = 0.989]）和妊娠率（26.4%对28.4%；P = 0.989）无显著差异。
通过平均GES测量的胚胎质量不受腹膜子宫内膜异位症的影响。同样，有和无子宫内膜异位症的不孕患者之间评估的生殖结局相似。
