Bayuaji Hartanto, Susilo Artha Falentin Putri, Tjandraprawira Kevin Dominique
Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Padjadjaran Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.
Bandung Fertility Center Limijati Women and Children Hospital, Bandung, Indonesia.
Obstet Gynecol Int. 2024 Sep 6;2024:4139821. doi: 10.1155/2024/4139821. eCollection 2024.
This study is to compare the time to pregnancy (TTP) between patients with endometriosis and nonendometriosis undergoing fertilisation (IVF).This is an observational retrospective cohort study. We included 291 patients (53 with endometriosis and 238 without endometriosis) achieving biochemical pregnancy, whether singleton or multifetal (serum beta-hCG >5 mIU/mL), between 1st January 2014 and 31st March 2020. We excluded patients with incomplete case notes and those declining participation. Time to pregnancy is the interval between the time when infertility was established to the date of confirmed biochemical pregnancy, expressed in months. Endometriosis diagnosis includes any form of endometriosis through surgical confirmation. A statistical analysis was done through the Mann-Whitney test. Time to pregnancy was assessed through the Kaplan-Meier test. A value <0.05 is considered statistically significant.
Endometriosis patients had a shorter infertility duration (4 years vs. 5 years, =0.024). Both groups had similar median age and body mass index at presentation. There was no significant difference in the TTP between endometriosis and nonendometriosis groups (57.7 vs. 70.9 months, =0.060), further confirmed by a Cox regression test incorporating confounders (IVF protocol (OR: 1.482, 95% CI 0.667-3.292, and =0.334) and type of the cycle (OR 1.071, 95% CI 0.803-1.430, and =0.640)). The endometriosis group reached the maximum cumulative pregnancy rate at around 169 months postinfertility diagnosis, whilst the nonendometriosis group at around 255 months postinfertility diagnosis.
Time to pregnancy between endometriosis and nonendometriosis is not significantly different. However, infertility among patients with endometriosis tends to be shorter.
本研究旨在比较子宫内膜异位症患者与非子宫内膜异位症患者接受体外受精(IVF)后的受孕时间(TTP)。这是一项观察性回顾性队列研究。我们纳入了2014年1月1日至2020年3月31日期间实现生化妊娠的291例患者(53例患有子宫内膜异位症,238例未患子宫内膜异位症),无论妊娠为单胎还是多胎(血清β - hCG>5 mIU/mL)。我们排除了病历不完整的患者以及拒绝参与的患者。受孕时间是指从确诊不孕到确认生化妊娠日期之间的间隔,以月为单位表示。子宫内膜异位症的诊断包括通过手术确认的任何形式的子宫内膜异位症。通过曼 - 惠特尼检验进行统计分析。受孕时间通过卡普兰 - 迈耶检验进行评估。P值<0.05被认为具有统计学意义。
子宫内膜异位症患者的不孕持续时间较短(4年对5年,P = 0.024)。两组患者就诊时的中位年龄和体重指数相似。子宫内膜异位症组和非子宫内膜异位症组的受孕时间无显著差异(57.7对70.9个月,P = 0.060),纳入混杂因素的Cox回归检验进一步证实了这一点(IVF方案(OR:1.482,95% CI 0.667 - 3.292,P = 0.334)和周期类型(OR 1.071,95% CI 0.803 - 1.430,P = 0.640))。子宫内膜异位症组在不孕诊断后约169个月达到最大累积妊娠率,而非子宫内膜异位症组在不孕诊断后约255个月达到最大累积妊娠率。
子宫内膜异位症患者与非子宫内膜异位症患者的受孕时间无显著差异。然而,子宫内膜异位症患者的不孕时间往往较短。