Pregnancy Rates After Surgical Treatment of Deep Infiltrating Endometriosis in Infertile Patients With at Least 2 Previous In Vitro Fertilization or Intracytoplasmic Sperm Injection Failures
Pregnancy Rates After Surgical Treatment of Deep Infiltrating Endometriosis in Infertile Patients With at Least 2 Previous In Vitro Fertilization or Intracytoplasmic Sperm Injection Failures
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DOI：
10.1016/j.jmig.2019.08.032
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发表时间：
2020-07-01
影响因子：
4.1
通讯作者：
Roman, Horace
中科院分区：
文献类型：
--
作者：
Breteau, Pauline;Chanavaz-Lacheray, Isabella;Roman, Horace
研究目的：评估深部浸润性子宫内膜异位症（DIE）患者术后妊娠的概率，以及≥ 2次体外受精（IVF）或卵胞浆内单精子注射（ICSI）失败的患者。设计：回顾性研究，使用西北地区间子宫内膜异位症患者女性队列（CIRENDO）数据库中前瞻性记录的数据。设置：大学三级转诊中心。患者：年龄在43岁以下的不孕患者，曾经历≥ 2次IVF或ICSI失败，接受DIE手术治疗。干预措施：完全切除DIE。测量和主要结果：评估手术后的妊娠率。104名不孕不育患者在参与该数据库的7个不同中心接受了手术。77名女性打算术后妊娠。排除了四名通过卵子捐赠怀孕的患者，导致73名妇女的样本。患者的平均年龄为31.9岁（标准差[SD]，4.1），平均不孕症史为48.4个月（SD，26.5）。III期和IV期子宫内膜异位症记录在83.6%的患者。平均术后随访46.6个月（SD，20.5）。术后妊娠率为43.8%，从手术到妊娠的平均时间为11.1个月。21.8%的妊娠是自发的，31.2%是通过IVF获得的，21.8%是通过冷冻胚胎移植获得的，18.7%是通过IVF-ICSI获得的，3.1%是通过宫内授精获得的。多变量分析显示，卵巢手术，年龄>= 35岁，和第二阶段子宫内膜异位症与conception.Conclusion的概率：不孕妇女与>= 2 IVF-ICSI失败可能是指手术，因为它似乎与合理的术后妊娠率，特别是当卵巢囊肿手术是不需要或不进行。DIE的手术通常不会延迟受孕，因为它通常发生在手术后的一年内。(C)2019年AAGL。All rights reserved.
Study Objective: To assess the postoperative probabilities of pregnancy in patients with deep infiltrating endometriosis (DIE) and >= 2 previous in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) failures.Design: Retrospective study using data prospectively recorded in the North-West Inter Regional Female Cohort for Patients with Endometriosis (CIRENDO) database.Setting: University tertiary referral center.Patients: Infertile patients under the age of 43 years, having undergone >= 2 previous IVF or ICSI failures, who were surgically managed for DIE.Interventions: Complete excision of DIE.Measurements and Main Results: The pregnancy rate after surgery was assessed. One hundred and four infertile patients had surgery in 7 different centers participating in the database. Seventy-seven women intended to get pregnant postoperatively. Four patients who got pregnant by oocyte donation were excluded, resulting in a sample of 73 women. The mean patient age was 31.9 years (standard deviation [SD], 4.1), and the mean length of history of infertility was 48.4 months (SD, 26.5). Stage III and IV endometriosis were recorded in 83.6% of patients. The mean postoperative follow-up was 46.6 months (SD, 20.5). The postoperative pregnancy rate was 43.8% with a mean time from surgery to pregnancy of 11.1 months. 21.8% of pregnancies were spontaneous, 31.2% were obtained by IVF, 21.8% by frozen embryo transfer, 18.7% by IVF-ICSI, and 3.1% by intrauterine insemination. Multivariate analysis revealed that ovarian surgery, age >= 35 years old, and stage II endometriosis was associated with the probability of conception.Conclusion: Infertile women with >= 2 IVF-ICSI failures may be referred for surgery as it appears related to reasonable postoperative pregnancy rates, particularly when endometriomas surgery is either not required or not performed. Surgery for DIE does not routinely delay conception, as it usually occurs during the year following surgery. (C) 2019 AAGL. All rights reserved.