In vitro fertilization is a successful treatment in endometriosis-associated infertility
In vitro fertilization is a successful treatment in endometriosis-associated infertility
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DOI：
10.1016/j.fertnstert.2012.01.112
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发表时间：
2012-04-01
影响因子：
6.7
通讯作者：
Tanbo, Tom
中科院分区：
文献类型：
--
作者：
Opoien, Hans Kristian;Fedorcsak, Peter;Tanbo, Tom
目的：评估不同阶段子宫内膜异位症妇女的IVF和卵胞浆内单精子注射的成功率。设计：回顾性队列研究。设置：一所大学医院的生殖医学单位。患者：不孕妇女（n = 2，245）患有不同阶段的子宫内膜异位症或输卵管因素不孕症。干预措施：IVF或卵胞浆内单精子注射。主要结果测量：FSH剂量、获卵数、受精率、着床率、妊娠率（PR）、活产/持续PR。结果：子宫内膜异位症妇女的妊娠和活产/持续PR与输卵管因素不孕妇女相似，但美国生殖医学会（ASRM）I期和II期子宫内膜异位症患者的受精率较低，III期和IV期患者需要更多的FSH，获得的卵母细胞较少。将III期和IV期组分为有和无子宫肌瘤的患者显示，子宫肌瘤组需要更多的FSH，妊娠和活产/持续PR显着降低。结论：除子宫肌瘤患者外，子宫内膜异位症各阶段的不孕妇女与输卵管因素患者IVF和卵胞浆内单精子注射的成功率相同。这与欧洲人类生殖和胚胎学学会的建议所依据的系统评价形成了鲜明对比。（Fertil Steril（R）2012;97：912-8.（C）2012年由美国生殖医学协会。
Objective: To assess success rates of IVF and intracytoplasmic sperm injection in women with various stages of endometriosis.Design: Retrospective cohort study.Setting: Reproductive medicine unit in a university hospital.Patient(s): Infertile women (n = 2,245) with various stages of endometriosis or tubal factor infertility.Intervention(s): IVF or intracytoplasmic sperm injection.Main Outcome Measure(s): Dose of FSH, number of oocytes retrieved, fertilization rate, implantation rate, pregnancy rate (PR), live birth/ongoing PR.Result(s): Women with endometriosis had similar pregnancy and live birth/ongoing PR as did women with tubal factor infertility, but the American Society for Reproductive Medicine (ASRM) stage I and II endometriosis patients had a lower fertilization rate, and stage III and IV patients required more FSH and had fewer oocytes retrieved. Splitting the stage III and IV groups into patients with and without endometriomas showed that the endometrioma group required more FSH and had a significantly lower pregnancy and live birth/ongoing PR.Conclusion(s): With the exception of patients with endometrioma, infertile women with various stages of endometriosis have the same success rates with IVF and intracytoplasmic sperm injection as patients with tubal factor. This contrasts with the systematic review on which the European Society of Human Reproduction and Embryology bases its recommendations. (Fertil Steril (R) 2012;97:912-8. (C)2012 by American Society for Reproductive Medicine.)