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腹腔镜囊肿切除术能否改善子宫内膜异位囊肿患者的妊娠结局?一项前瞻性临床试验研究。

Can Laparoscopic Cystectomy Improve Pregnancy Outcomes in Endometrioma? A Prospective Clinical Trial Study.

作者信息

Hosseinimousa Sedigheh, Safdarian Leili, Aleyasin Ashraf, Aghahosseini Marzieh, Talebian Marzieh

机构信息

Department of Obstetrics and Gynecology and Reproductive, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.Email:

Department of Obstetrics and Gynecology and Reproductive, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Int J Fertil Steril. 2022 Aug 21;16(3):206-210. doi: 10.22074/IJFS.2021.521378.1066.

Abstract

The purpose of this prospective study was to compare the ovarian response and pregnancy outcomes
in the infertile women with endometrioma undergoing assisted reproductive technologies (ART) in two
groups, who were underwent laparoscopic cystectomy and received gonadotropin releasing hormone-agonist
(GnRH-agonist) and who only received GnRH-agonist without any surgery.
Materials and Methods: In this prospective clinical trial study, 79 infertile women with asymptomatic endometriomas
cyst (2-6 cm) were enrolled and randomly assigned to two groups. First group underwent laparoscopic
cystectomy and received GnRH-agonist. Second group only received GnRH-agonist without any surgery. Following
ovulation induction, all patients underwent intracytoplasmic sperm injection (ICSI). Different parameters
such as the number of retrieved oocytes and embryos; were made our outcomes that analyzed using SPSS.
Results: The pregnancy rate, chemical and clinical, and live birth rate were higher in the combined group,
although these differences were not statistically significant (48.48% vs. 30.8%, P=0.12, 36.36% vs. 25.6%,
P=0.32, 36.36% vs. 23.1%, P=0.29). The number of injections, antral follicles, retrieved oocytes, mature oocytes,
total embryos, transferred embryos and duration of stimulation were similar in two groups.
Conclusion: Laparoscopic cystectomy followed by receiving GnRH-agonist improves pregnancy outcomes in endometrioma
prior to treatment with ART (registration number: IRCT201106116689N2).

摘要

本前瞻性研究的目的是比较两组接受辅助生殖技术(ART)的子宫内膜异位症不孕女性的卵巢反应和妊娠结局,一组接受腹腔镜囊肿切除术并使用促性腺激素释放激素激动剂(GnRH-激动剂),另一组仅使用GnRH-激动剂且未进行任何手术。

材料与方法

在这项前瞻性临床试验研究中,79例无症状子宫内膜异位囊肿(2-6厘米)的不孕女性被纳入并随机分为两组。第一组接受腹腔镜囊肿切除术并使用GnRH-激动剂。第二组仅使用GnRH-激动剂且未进行任何手术。诱导排卵后,所有患者均接受卵胞浆内单精子注射(ICSI)。将诸如获取的卵母细胞和胚胎数量等不同参数作为我们的结局指标,使用SPSS进行分析。

结果

联合组的妊娠率、生化妊娠率和临床妊娠率以及活产率更高,尽管这些差异无统计学意义(48.48%对30.8%,P = 0.12;36.36%对25.6%,P = 0.32;36.36%对23.1%,P = 0.29)。两组的注射次数、窦卵泡数、获取的卵母细胞数、成熟卵母细胞数、总胚胎数、移植胚胎数和刺激持续时间相似。

结论

在接受ART治疗前,腹腔镜囊肿切除术联合GnRH-激动剂可改善子宫内膜异位症患者的妊娠结局(注册号:IRCT201106116689N2)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2afb/9396010/552ff1ce67eb/Int-J-Fertil-Steril-16-206-g01.jpg

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