Chang M Y, Chiang C H, Hsieh T T, Soong Y K, Hsu K H
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC.
J Assist Reprod Genet. 1997 Feb;14(2):76-82. doi: 10.1007/BF02765774.
Our purpose was to evaluate the outcomes of gamete intrafallopian transfer (GIFT) therapy in patients with endometriosis.
One hundred eight GIFT cycles performed under the indication of endometriosis were compared to 156 GIFT cycles with indications of other disease entities. A maximum of seven oocytes was transferred into one or both fimbriate ends with prepared spermatozoa. Clinical pregnancy rates and outcomes were evaluated according to Mantel-Haenszel's chi-square test. Multiple logistic regression analysis was performed to determine factors influencing the success on pregnancy in the total treatment cycles.
The anthropological variables, such as age of patients, duration of infertility, and semen grading, were comparable in both groups. The responses to controlled ovarian hyperstimulation (COH) were progressively decreased while increasing the severity of endometriosis conditions such as nonendometriosis, mild-form endometriosis, and advanced-form endometriosis patients. However, there were no significant differences in the clinical pregnancy rates (40.4, 36.7, and 41.7%, respectively), multiple pregnancy rates (34.9, 27.3, and 45.0%, respectively), and early pregnancy loss rates (27.0, 18.2, and 30.0%, respectively). Multivariate statistics of pregnancy rates that adjusted the effects of patients' age, tubal health, presence of active endometriosis and/or endometriomas, number of oocytes transferred, and quality of sperm exhibited no statistical significance between endometriosis and nonendometriosis groups.
Our data show that patients with records of endometriosis have both a decreased ovarian response to gonadotropin stimulation and a decreased number of retrieved oocytes. Since the number of oocytes needed for the GIFT procedure is limited, pregnancy results for patients in the study group were comparable with those for patients in the control group.
我们的目的是评估子宫内膜异位症患者配子输卵管内移植（GIFT）治疗的结果。
将108个在子宫内膜异位症指征下进行的GIFT周期与156个有其他疾病实体指征的GIFT周期进行比较。最多将7个卵母细胞与准备好的精子一起移植到一个或两个伞端。根据Mantel-Haenszel卡方检验评估临床妊娠率和结局。进行多因素逻辑回归分析以确定影响总治疗周期妊娠成功的因素。
两组患者的人类学变量，如患者年龄、不孕持续时间和精液分级，具有可比性。随着子宫内膜异位症病情严重程度增加，如非子宫内膜异位症、轻度子宫内膜异位症和重度子宫内膜异位症患者，对控制性卵巢过度刺激（COH）的反应逐渐降低。然而，临床妊娠率（分别为40.4%、36.7%和41.7%）、多胎妊娠率（分别为34.9%、27.3%和45.0%）和早期妊娠丢失率（分别为27.0%、18.2%和30.0%）之间无显著差异。调整患者年龄、输卵管健康状况、活动性子宫内膜异位症和/或子宫内膜瘤的存在、移植卵母细胞数量和精子质量影响后的妊娠率多因素统计显示，子宫内膜异位症组和非子宫内膜异位症组之间无统计学意义。
我们的数据表明，有子宫内膜异位症记录的患者对促性腺激素刺激的卵巢反应降低，回收的卵母细胞数量减少。由于GIFT程序所需的卵母细胞数量有限，研究组患者的妊娠结果与对照组患者相当。
