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手术前胚胎冷冻保存对子宫内膜异位症体外受精患者临床结局的影响。

Effect of embryo cryopreservation before surgery on clinical outcomes in IVF patients with endometrioma.

作者信息

Takahashi Nozomi, Kawahara Yuma, Harada Miyuki, Makabe Tomoko, Izumi Gentaro, Wada-Hiraike Osamu, Hirota Yasushi, Osuga Yutaka

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine The University of Tokyo Tokyo Japan.

出版信息

Reprod Med Biol. 2025 May 6;24(1):e12654. doi: 10.1002/rmb2.12654. eCollection 2025 Jan-Dec.

Abstract

PURPOSE

This study evaluated whether embryo cryopreservation before surgery (ECBS) improves clinical outcomes in in vitro fertilization (IVF) patients with endometrioma.

METHODS

This retrospective study included patients aged 28-42 years with endometrioma who underwent oocyte retrieval at our hospital from 2019 to 2022. Seventeen patients who underwent ECBS and 43 patients who underwent embryo transfer (ET) without surgery were included. Patient characteristics, reproductive outcomes, and obstetric outcomes were compared between the groups.

RESULTS

Maximum cyst size was significantly larger in the ECBS group than in the control group. The abortion rate per pregnancy was significantly lower (0% vs. 35.5%) in the ECBS group than in the control group. The ongoing pregnancy rate per case was significantly higher in the ECBS group than in the control group (88.2% vs. 58.1%), while the time to ongoing pregnancy was similar. Among patients in the ECBS group who experienced live births, 84.6% became pregnant following three or fewer ET attempts. Multivariate analysis revealed that ECBS was the only factor associated with ongoing pregnancy. The rates of perinatal complications are comparable between the groups.

CONCLUSIONS

ECBS is an effective method to improve reproductive outcomes in IVF patients with endometrioma without prolonging the time to pregnancy.

摘要

目的

本研究评估了手术前胚胎冷冻保存(ECBS)是否能改善子宫内膜异位症体外受精(IVF)患者的临床结局。

方法

这项回顾性研究纳入了2019年至2022年在我院接受取卵的28至42岁患有子宫内膜异位症的患者。其中包括17例行ECBS的患者和43例未手术直接进行胚胎移植(ET)的患者。对两组患者的特征、生殖结局和产科结局进行了比较。

结果

ECBS组的最大囊肿尺寸显著大于对照组。ECBS组每次妊娠的流产率显著低于对照组(0%对35.5%)。ECBS组每例患者的持续妊娠率显著高于对照组(88.2%对58.1%),而达到持续妊娠的时间相似。在ECBS组中经历活产的患者中,84.6%在三次或更少的ET尝试后怀孕。多因素分析显示,ECBS是与持续妊娠相关的唯一因素。两组围产期并发症的发生率相当。

结论

ECBS是一种改善子宫内膜异位症IVF患者生殖结局的有效方法,且不会延长怀孕时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd3/12056301/446c84d4a03d/RMB2-24-e12654-g001.jpg

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