Fakih H, Marshall J
Saginaw Cooperative Hospitals, Inc., Michigan 48602.
Fertil Steril. 1994 Oct;62(4):799-801. doi: 10.1016/s0015-0282(16)57007-1.
To evaluate prospectively the impact of subtle tubal disorders on GIFT pregnancy rates in women with pelvic endometriosis.
A prospective comparison of pregnancy rates in different stages of endometriosis while controlling for the presence of tubal abnormalities.
A total of 146 patients with endometriosis underwent 201 GIFT procedures. During laparoscopy special attention was brought to the fallopian tubes and any anatomical disorders were recorded. Tubal abnormalities included tubal sacculations, diverticulae, convolutions, phimosis, fimbrial agglutination, and peritubal adhesions. Best tube was considered in the final analysis.
The presence of tubal abnormalities significantly lowered the pregnancy rates in all stages of endometriosis. When we controlled for age, semen characteristics, number of mature oocytes transferred, and tubal status, the extent of anatomical tubal disorders was the most important prognostic factor in determining pregnancy outcome.
The extent of tubal abnormalities rather than the stage of endometriosis seems to be an important prognostic factor in determining GIFT pregnancy rates. Couples should be counseled accordingly and accurate prognostic parameters should be explained before enrollment in a GIFT program.
前瞻性评估细微输卵管疾病对盆腔子宫内膜异位症患者配子输卵管内移植（GIFT）妊娠率的影响。
在控制输卵管异常存在的情况下，对子宫内膜异位症不同阶段的妊娠率进行前瞻性比较。
共有146例子宫内膜异位症患者接受了201次GIFT手术。在腹腔镜检查期间，特别关注输卵管，并记录任何解剖学异常。输卵管异常包括输卵管囊状扩张、憩室、盘绕、狭窄、伞端粘连和输卵管周围粘连。最终分析时考虑最佳的输卵管。
输卵管异常的存在显著降低了子宫内膜异位症各阶段的妊娠率。当我们控制年龄、精液特征、移植的成熟卵母细胞数量和输卵管状况时，输卵管解剖学疾病的程度是决定妊娠结局的最重要预后因素。
输卵管异常的程度而非子宫内膜异位症的阶段似乎是决定GIFT妊娠率的重要预后因素。应相应地为夫妇提供咨询，并在纳入GIFT计划之前解释准确的预后参数。
