Impact of laparoscopic cystectomy on fecundity of infertility patients with ovarian endometrioma
Impact of laparoscopic cystectomy on fecundity of infertility patients with ovarian endometrioma
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DOI：
10.1111/j.1447-0756.2007.00630.x
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发表时间：
2007-10-01
影响因子：
1.6
通讯作者：
Saito, Hidekazu
中科院分区：
文献类型：
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作者：
Nakagawa, Koji;Ohgi, Shirei;Saito, Hidekazu
目的：探讨腹腔镜下卵巢子宫内膜瘤切除术治疗不孕症的效果，评价其妊娠结局。方法：回顾性研究。自2002年8月至2006年2月，我中心共收治33例卵巢子宫内膜异位瘤不孕症患者行腹腔镜膀胱切除术。根据腹腔镜检查结果将33例患者分为两组；10例为需要辅助生殖技术（ART）治疗的患者（IVF亚组），23例为不需要辅助生殖技术治疗但接受常规不孕治疗的患者（非IVF亚组）。同期将70例年龄匹配且接受ART治疗且不进行腹腔镜检查的患者定义为对照组（对照组）。随访至腹腔镜术后12个月，计算非体外受精亚组的累计妊娠率。结果：体外受精组和非体外受精组患者年龄、不孕持续时间和子宫内膜瘤大小相等。IVF亚组修订后的美国生殖医学学会（r-ASRM）评分显著高于非IVF组（P < 0.05）。IVF亚组和非IVF亚组腹腔镜膀胱切除术后妊娠率分别为50.0%和60.9%。体外受精组和非体外受精组的这一比例略高于对照组（41.4%），但差异不显著。腹腔镜术后12个月，非体外受精组累计妊娠率达52.2%。结论：卵巢子宫内膜异位瘤不孕症患者在ART治疗前应进行腹腔镜手术，这不仅是为了确定疗程，也是为了在ART治疗中建立良好的盆腔条件以诱导妊娠。
Aim: To clarify the effect of laparoscopic cystectomy for ovarian endometrioma in infertility patients, the pregnancy outcome was evaluated.Methods:This was a retrospective study. From August 2002 to February 2006, 33 infertility patients with ovarian endometrioma underwent laparoscopic cystectomy at our center. According to the laparoscopic findings 33 were divided into two groups; 10 were evaluated as the patients who need assisted reproductive technologies (ART) treatment (IVF subgroup) and 23 were evaluated as the patients who do not need ART treatment but conventional infertility treatment (non-IVF subgroup). During the same period, 70 patients who were age-matched and received ART treatment without laparoscopy were defined as control (control group). Following up to 12 months after laparoscopy, the cumulative pregnancy rate in the non-IVF subgroup was calculated.Results: The patients age, duration of infertility and size of endometrioma were equal in the IVF and the non-IVF subgroups. The revised-American Society of Reproductive Medicine (r-ASRM) score in the IVF subgroup was significantly higher than that in the non-IVF group (P < 0.05). The pregnancy rates after laparoscopic cystectomy in IVF and non-IVF subgroups were 50.0% and 60.9%, respectively. These rates in the IVF and the non-IVF groups were slightly higher than that in control group (41.4%), but these differences were not significant. The cumulative pregnancy rate in the non-IVF group reached 52.2%, 12 months after laparoscopic surgery.Conclusions: Laparoscopic surgery should be performed prior to ART treatment not only for making a decision about the treatment course but also for establishing a good pelvic condition to induce a pregnancy during ART treatment in infertility treatment with ovarian endometrioma.