Endometriosis and ART: A prior history of surgery for OMA is associated with a poor ovarian response to hyperstimulation.
Endometriosis and ART: A prior history of surgery for OMA is associated with a poor ovarian response to hyperstimulation.
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DOI：
10.1371/journal.pone.0202399
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Chapron C
中科院分区：
文献类型：
--
作者：
Bourdon M;Raad J;Dahan Y;Marcellin L;Maignien C;Even M;Pocate-Cheriet K;Lamau MC;Santulli P;Chapron C
许多生育能力可能因子宫内膜异位症而受损的妇女需要辅助生殖技术（ART）才能怀孕。然而，卵巢子宫内膜异位症（OMA）对卵巢过度刺激反应性的影响尚未明确。评估卵巢癌患者卵巢对刺激反应不良（POR）的风险和ART结局。我们于2012年10月1日至2015年12月31日在一所三级护理大学医院进行了一项大型观察性对照匹配队列研究。在年龄和抗苗勒管激素（AMH）水平匹配后，201名患有OMA的不孕妇女（OMA组）和402名接受ART手术的无病妇女（对照组）被纳入研究。我们测量的主要结果是对过度刺激的POR（即，≤ 3个获卵或取消周期）、临床妊娠率和活产率。所有患有子宫内膜异位症的妇女都接受了ART前的检查，以获得对其疾病的准确诊断和分期。OMA的诊断是基于已发表的影像学标准（通过经阴道超声或磁共振成像获得）或对有子宫内膜异位症手术史的患者进行组织学分析。采用单变量和多变量logistic回归模型进行统计学分析。OMA组过度刺激的POR发生率显著高于对照组[分别为62/201（30.8%）vs 90/402（22.3%）; p = 0.02]。然而，在临床妊娠率[分别为53/151（35%）与134/324（41.3%）; p = 0.23]和活产率[分别为39/151（25.8%）与99/324（30.5%）; p = 0.33]方面，未发现OMA组与对照组之间存在显著差异。通过多变量分析，发现OMA的既往手术史是与刺激POR相关的独立因素[OR = 2.1; 95%CI：1.1-4.0]，与无既往手术史的OMA不同[OR：1.5; 95%CI：0.9-2.2]。ART治疗期间存在OMA增加了POR对过度刺激的风险，尽管活产率未受影响。此外，患有OMA和既往接受过OMA手术被确定为POR的独立风险因素。
Many women whose fertility may have been impaired by endometriosis require assisted reproductive technology (ART) in order to become pregnant. However, the influence of ovarian endometriosis (OMA) on ovarian responsiveness to hyperstimulation has not been clearly established. To evaluate the risk of a poor ovarian response (POR) to stimulation and ART outcomes in women with OMA. We conducted a large observational controlled matched cohort study in a tertiary care university hospital between 01/10/2012 and 31/12/2015. After matching by age and anti-Müllerian hormone (AMH) levels, 201 infertile women afflicted with OMA (the OMA group) and 402 disease-free women (the control group) undergoing an ART procedure were included in the study. The main outcomes that we measured were a POR to hyperstimulation (i.e., ≤ 3 oocytes retrieved, or cancelled cycles), the clinical pregnancy rate, and the live birth rate. All of the women with endometriosis underwent a pre-ART work-up, in order to obtain an accurate diagnosis and staging of their disease. An OMA diagnosis was based on published imaging criteria (obtained by transvaginal sonography or magnetic resonance imaging) or on histological analysis for patients with a prior history of endometriosis surgery. The statistical analyses were conducted using univariate and multivariate logistic regression models. The incidence of a POR to hyperstimulation was significantly higher for the OMA group than for the control group [62/201 (30.8%) versus 90/402 (22.3%), respectively; p = 0.02]. However, no significant differences were found between the OMA and the control group in terms of the clinical pregnancy rate [53/151 (35%) versus 134/324 (41.3%), respectively; p = 0.23] and the live birth rate [39/151 (25.8%) versus 99/324 (30.5%), respectively; p = 0.33]. By multivariate analysis, a prior history of surgery for OMA was found to be an independent factor associated with a POR to stimulation [OR = 2.1; 95% CI: 1.1–4.0], unlike OMA without a prior history of surgery [OR: 1.5; 95% CI: 0.9–2.2]. The presence of OMA during ART treatment increased the risk of a POR to hyperstimulation, although the live birth rate was not affected. Furthermore, having OMA and having previously undergone surgery for OMA was identified as an independent risk factor for a POR.
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影响因子：
9.8
作者：
Busacca, Mauro;Riparini, Jennifer;Candiani, Massimo
通讯作者：
Candiani, Massimo
影响因子：
6.7
作者：
Chapron, Charles;Lafay-Pillet, Marie-Christine;de Ziegler, Dominique
通讯作者：
de Ziegler, Dominique
使用 GnRH 拮抗剂方案进行受控卵巢刺激时卵巢反应高低的预后模型。
DOI：
10.1093/humrep/deu090
发表时间：
2014-08
期刊：
Human reproduction (Oxford, England)
影响因子：
--
作者：
Broekmans FJ;Verweij PJ;Eijkemans MJ;Mannaerts BM;Witjes H
通讯作者：
Witjes H
DOI：
10.1093/humrep/des101
发表时间：
2012-06
期刊：
Human reproduction (Oxford, England)
影响因子：
--
作者：
Anckaert E;Smitz J;Schiettecatte J;Klein BM;Arce JC
通讯作者：
Arce JC
影响因子：
7.1
作者：
Chapron, C;Vieira, M;Dousset, B
通讯作者：
Dousset, B