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影响子宫内膜异位症女性腹腔镜手术后体外受精成功率的因素。

Factors Affecting IVF Success after Laparoscopic Surgery in Women with Endometriosis.

作者信息

Mehdizadehkashi Abolfazl, Chaichian Shahla, Derakhshan Roya, Farzaneh Farahnaz, Govahi Azam, Mohammadzadeh Azar, Nikfar Banafsheh, Kabir Anaraki Yasaman

机构信息

Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran.

Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Med J Islam Repub Iran. 2025 Apr 29;39:61. doi: 10.47176/mjiri.39.61. eCollection 2025.

Abstract

BACKGROUND

Considering low-quality evidence regarding the impact of laparoscopic surgery on in vitro fertilization (IVF) success rates in women with endometriosis, our research aimed to evaluate IVF success rates and their influential factors in women with endometriosis-related infertility who underwent laparoscopic surgery.

METHODS

In a retrospective cohort study, we included women aged 15 to 40 years diagnosed with endometriosis-related infertility who underwent laparoscopic surgery in a university hospital. Women with severe male factor infertility, adenomyosis, uterine myomas, premature ovarian insufficiency, incomplete information, or inaccessible data from infertility centers were excluded. Data were collected from the Endometriosis Data Registry approved by the Iran University of Medical Sciences under code number 1400-2-65-21233, including age, body mass index, infertility duration, endometriosis severity, and Anti-Müllerian hormone levels before IVF. IVF success was considered by an embryonic heartbeat identification during an ultrasound exam, that is, a clinical pregnancy. Independent sample t test, Mann-Whitney, and chi-square tests were applied for single-variable analysis, and logistic regression was used for multivariable analysis.

RESULTS

Of 55 eligible patients, IVF was successful in 23 (41.81%). The mean age of participants was 34.98 years, with a standard deviation of 5.93 years. Endometriomas were observed in 42 (76%) of the participants; unilateral endometriomas were more common than bilateral (25 [45.5%] vs 17 [30.9%]). No significant differences were identified between the IVF-positive and IVF-negative groups regarding clinical and demographic characteristics.

CONCLUSION

Laparoscopic surgery in women with deep infiltrating endometriosis enhances IVF success and increases pregnancy rate.

摘要

背景

鉴于关于腹腔镜手术对子宫内膜异位症女性体外受精(IVF)成功率影响的证据质量较低,我们的研究旨在评估接受腹腔镜手术的子宫内膜异位症相关性不孕女性的IVF成功率及其影响因素。

方法

在一项回顾性队列研究中,我们纳入了年龄在15至40岁之间、被诊断为子宫内膜异位症相关性不孕且在大学医院接受腹腔镜手术的女性。排除患有严重男性因素不育、子宫腺肌病、子宫肌瘤、卵巢早衰、信息不完整或无法从不孕不育中心获取数据的女性。数据收集自伊朗医科大学批准的子宫内膜异位症数据登记处,代码为1400 - 2 - 65 - 21233,包括年龄、体重指数、不孕持续时间、子宫内膜异位症严重程度以及IVF前的抗苗勒管激素水平。IVF成功定义为超声检查时识别到胚胎心跳,即临床妊娠。采用独立样本t检验、曼 - 惠特尼检验和卡方检验进行单变量分析,采用逻辑回归进行多变量分析。

结果

55例符合条件的患者中,23例(41.81%)IVF成功。参与者的平均年龄为34.98岁,标准差为5.93岁。42例(76%)参与者观察到子宫内膜异位囊肿;单侧子宫内膜异位囊肿比双侧更常见(25例[45.5%]对17例[30.9%])。IVF阳性组和IVF阴性组在临床和人口统计学特征方面未发现显著差异。

结论

对深部浸润性子宫内膜异位症女性进行腹腔镜手术可提高IVF成功率并增加妊娠率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cb8/12309351/a70b23d5616b/mjiri-39-61-g001.jpg

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