Ankara Medipol University Faculty of Medicine, Department of Gynaecology and Obstetrics, Ankara, Turkey.
Ankara University Faculty of Medicine, Department of Gynaecology and Obstetrics, Ankara, Turkey.
JBRA Assist Reprod. 2023 Sep 12;27(3):401-406. doi: 10.5935/1518-0557.20220067.
Endometrioma surgery is associated with a reduction in ovarian reserve. However, removal of an endometrioma may increase the likelihood of a spontaneous conception. The objective of this study was to assess the pre-operative and operative variables affecting spontaneous conception following endometrioma surgery.
Data from 211 women ≤40 years of age who underwent an endometrioma surgery at a university-based infertility clinic between January 2005 and June 2020 were reviewed retrospectively. The main outcome measure was spontaneous clinical pregnancy. We had 84 women with and 127 women without a successful spontaneous conception making up the case and control groups.
The median ages of the cases and controls were 27 and 32 years, respectively (p<0.001). The rate of recurrence was significantly lower in the spontaneous conception group when compared to controls (29.8% vs. 52.8%, respectively; p=0.001). Our results showed no differences in the number, size, or side of the endometriomas in both groups. Multivariate logistic regression analysis showed significant independent effects of age (B: -.166, OR {odds ratio}: 0.847, 95% CI {confidence interval}: 0.791-0.907, p<0.001), recurrence (B: -1.030, OR: 0.357, 95% CI: 0.188-0.678, p=0.002), and laparoscopic surgery rather than laparotomy (B: 1.585, OR: 4.879, 95% CI: 1.029-23.133, p=0.046) for spontaneous conception.
The size, number and bilaterality of the endometrioma did not affect the spontaneous conception likelihood following surgical removal. However, increasing age and recurrence are negatively associated with the likelihood of spontaneous conception. Laparoscopic surgery may increase the chance of spontaneous conception when compared to laparotomy.
子宫内膜异位症手术会导致卵巢储备功能下降。然而，切除子宫内膜异位症可能会增加自然受孕的可能性。本研究旨在评估影响子宫内膜异位症手术后自然受孕的术前和手术变量。
回顾性分析了 2005 年 1 月至 2020 年 6 月期间在一家大学不孕诊所接受子宫内膜异位症手术的 211 名≤40 岁的女性患者的数据。主要结局指标为自然临床妊娠。我们将 84 名成功自然受孕的患者和 127 名未成功自然受孕的患者分为病例组和对照组。
病例组和对照组的中位年龄分别为 27 岁和 32 岁（p<0.001）。与对照组相比，自然受孕组的复发率明显较低（分别为 29.8%和 52.8%；p=0.001）。两组的子宫内膜异位症数量、大小或侧别无差异。多变量逻辑回归分析显示，年龄（B：-0.166，OR：0.847，95%CI：0.791-0.907，p<0.001）、复发（B：-1.030，OR：0.357，95%CI：0.188-0.678，p=0.002）和腹腔镜手术而非剖腹手术（B：1.585，OR：4.879，95%CI：1.029-23.133，p=0.046）对自然受孕有显著的独立影响。
子宫内膜异位症的大小、数量和双侧性并不影响手术后自然受孕的可能性。然而，年龄的增加和复发与自然受孕的可能性呈负相关。与剖腹手术相比，腹腔镜手术可能会增加自然受孕的机会。
