未行手术治疗的卵巢子宫内膜异位囊肿对体外受精-胚胎移植结局的影响

摘要

Objective To investigate the ovarian response, embryo quality and others outcomes of patients with ovarian endometriosis cyst and no surgery performed treatment before in vitro fertilization-embryo transfer(IVF-ET).Methods The clinical data in infertility women of ovarian endometriosis cyst with no surgery treatment performed in reproductive medicine center in the second hospital of Hebei medical university undergoing IVF-ET were performed by retrospective analysis.Fifty-eight cases of ovarian endometriosis cyst with no surgical treatment was used as endometriosis(EM)group,with the same period 5 5 cases of tubal factor in IVF was used as control group.GnRH-a super long protocol was used for the ovarian stimulation.Clinical indexes(such as ovarian response to gonadotropin,number of oocytes),laboratory indexes(such as number of good quality embryos)and IVF pregnancy outcome were observed and compared between the EM group and the control group.Results There were no significant difference in the mean age,the duration of infertility,the base follicle stimulating hormone level,the duration of goadotropins,the goadotropins consumption,the number of transferred embryos between the EM group and control group (P>0.05 ).The serum estradiol level on the human chorionic gonadotropin inj ection day,the number of retrieval oocytes in EM group,were lower than those in the control group,and the differences were statistically significant(P<0.05).In the EM group the fertilization rate,the high quality embryo rate were lower than those in the control group, the difference was statistically significant(P<0.05).The clinical pregnancy rate in the EM group was lower than that in the control group,but there was no statistically significant difference. Conclusion Endometriosis cyst may have certain negative effects of ovarian response and embryo quality in IVF.It may reduce the number of retrieval oocytes and good quality embryos,which could eventually affect pregnancy outcomes.%目的：观察卵巢子宫内膜异位囊肿中未行手术治疗的患者进行体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)时的卵巢反应性及胚胎质量等结局。方法回顾性分析河北医科大学第二医院生殖医学科行 IVF-ET中的未行手术治疗的卵巢子宫内膜异位囊肿患者的临床资料。未行手术治疗的卵巢子宫内膜异位囊肿患者58例作为子宫内膜异位症(endometriosis,EM)组,以同期单纯因输卵管因素行首次体外受精(in vitro fertilization,IVF)患者55例作为对照组,均采用超长方案。比较EM组和对照组患者IVF临床指标、实验室指标及妊娠的结局。结果① EM组与对照组年龄、不孕年限、基础促卵泡素水平、促性腺激素使用时间和剂量、移植胚胎数差异均无统计学意义(P>0.05)；②EM组人绒毛膜促性腺激素注射日血清雌二醇、获卵数均低于对照组,差异有统计学意义(P<0.05)；③EM组受精率、优质胚胎率均低于对照组,差异有统计学意义(P<0.05)；④EM组临床妊娠率稍低于对照组,但差异无统计学意义(P>0.05)。结论 IVF中子宫内膜异位囊肿对卵巢反应性及胚胎质量有一定的不良影响,导致获卵数和优质胚胎减少,从而可能最终影响妊娠结局。