Department of Obstetrics and Gynaecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, Sichuan, China.
J Obstet Gynaecol Res. 2023 Dec;49(12):2946-2951. doi: 10.1111/jog.15794. Epub 2023 Sep 18.
To assess the pregnancy outcomes and associated influencing factors of pregnancy after hysteroscopy combined with laparoscopy treatment in infertile patients with minimal/mild endometriosis.
A retrospective study.
West China Second University Hospital of Sichuan University.
We enrolled 898 infertile women who had their minimal/mild endometriosis lesions removed by laparoscopy, including 271 patients additionally diagnosed with endometrial polyps who also underwent hysteroscopic polypectomy.
Based on the existence of endometrial polyps, patients with minimal/mild endometriosis were enrolled and divided into polyps group and non-polyps group.
Pregnancy outcomes.
A total of 271 women with minimal/mild endometriosis were included in polyps group while 491 women with minimal/mild endometriosis were included in non-polyps group. The pregnancy rate of polyps group was not statistically significant compared with non-polyp group (60.15% vs. 58.25%). The pregnancy rate was higher among patients with polyps ≥1 cm (76.06%, 54/71) than patients with polyps <1 cm (54.50%, 109/200) or patients without polyps (58.25%, 286/491) (p = 0.006). The pregnancy rate was higher for patients with multiple polyps (67.86%, 95/140) than for patients with single polyp (51.91%, 68/131) or without polyps (p = 0.025).
Among women with minimal/mild endometriosis, hysteroscopic polypectomy did significantly increase fertility in infertile patients with multiple polyps or size of polyp ≥1 cm compared with those without endometrial polyps, single polyp, and size of polyp <1 cm. The size and number of polyps were independently associated with the reproductive ability of women with minimal/mild endometriosis.
评估宫腔镜联合腹腔镜治疗轻度子宫内膜异位症不孕患者的妊娠结局及相关影响因素。
回顾性研究。
四川大学华西第二医院。
我们纳入了 898 例因腹腔镜下切除轻度子宫内膜异位症病变而不孕的患者,其中 271 例还被诊断为子宫内膜息肉,同时接受了宫腔镜息肉切除术。
根据是否存在子宫内膜息肉,将轻度子宫内膜异位症患者分为息肉组和非息肉组。
妊娠结局。
共纳入 271 例轻度子宫内膜异位症合并息肉患者归入息肉组,491 例轻度子宫内膜异位症无息肉患者归入非息肉组。息肉组的妊娠率与非息肉组相比差异无统计学意义(60.15%比 58.25%)。息肉≥1cm 的患者妊娠率(76.06%,54/71)高于息肉<1cm 的患者(54.50%,109/200)和无息肉的患者(58.25%,286/491)(p=0.006)。多发性息肉患者的妊娠率(67.86%,95/140)高于单发性息肉患者(51.91%,68/131)和无息肉患者(p=0.025)。
对于轻度子宫内膜异位症不孕患者,与无子宫内膜息肉、单发性息肉和息肉<1cm 的患者相比,宫腔镜息肉切除术可显著提高多发性息肉或息肉≥1cm 患者的生育能力。息肉的大小和数量与轻度子宫内膜异位症患者的生育能力独立相关。