Laparoscopic Treatment of Endometrioma-Associated Infertility and Pregnancy Outcome
Laparoscopic Treatment of Endometrioma-Associated Infertility and Pregnancy Outcome
复制标题
腹腔镜治疗子宫内膜异位症相关不孕症和妊娠结局
DOI：
10.1159/000066292
复制
发表时间：
2002
影响因子：
2.1
通讯作者：
M. Ishikawa
中科院分区：
文献类型：
--
作者：
N. Takuma;K. Sengoku;Bochen Pan;Keiko Wada;Tomofumi Yamauchi;T. Miyamoto;Daisuke Ohsumi;M. Ishikawa
卵巢子宫内膜异位瘤对激素抑制的药物治疗反应不佳，通常需要手术切除子宫内膜异位瘤。在这项研究中，我们试图确定腹腔镜治疗卵巢子宫内膜异位症相关不孕症的最佳腹腔镜手术。在腹腔镜治疗后未接受IVF-ET的患者中，子宫内膜异位囊肿完全切除术后的妊娠率明显低于囊壁电凝开窗术后的妊娠率。在接受 IVF-ET 的患者中，接受完全膀胱切除术和电凝囊壁开窗术的患者之间的卵巢反应没有差异。然而，单纯抽吸患者的妊娠率在统计学上低于抽吸后乙醇固定的患者。因此，对于不需要后续IVF-ET的患者，囊壁电凝开窗术是合适的，而对于需要后续IVF-ET的患者，乙醇固定可能是更好的选择。
Ovarian endometriomas do not respond well to medical treatment with hormonal suppression, and surgical removal of the endometriomas is usually required. In this study, we attempt to identify the optimal laparoscopic procedures in laparoscopic treatment of ovarian-endometrioma-associated infertility. Among cases in which patients received no IVF-ET after the laparoscopic treatment, the pregnancy rate after complete cystectomy of endometriomas was statistically lower than that after fenestration with electrocoagulation of the cyst wall. Among cases in which patients received IVF-ET, there was no difference in ovarian response between patients that had complete cystectomy and fenestration with electrocoagulation of the cyst wall. However, the pregnancy rate in patients who had aspiration alone was statistically lower than that in patients who had aspiration followed by ethanol fixation. Thus, it appears that for patients who do not require follow-up IVF-ET, fenestration with electrocoagulation of the cyst wall is suitable, whereas for patients who need follow-up IVF-ET, ethanol fixation may be a better choice.