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目的:探讨子宫内膜异位症(EMs)不孕患者应用辅助生殖技术(ART)的治疗结局。方法:回顾性分析2006.01-2008.02期间在我中心行ART治疗的EMs患者。比较以下各组的治疗结局:行常规体外受精-胚胎移植/卵胞浆内单精子显微注射(IVF/ICSI-ET)的EMs患者(n=42,48个周期)与单纯输卵管因素患者(n=1060,1211个周期);采用3种超排卵方案的EMs患者(n=42,48个周期);行卵巢囊肿穿刺术后,病理结果确诊为EMs的患者(n=16,16个周期)与非EMs单纯囊肿患者(n=79,79个周期);接受夫精人工授精(AIH)治疗,采用自然周期(51个周期)和诱导排卵周期(31个周期)的EMs患者。结果:EMs患者的临床妊娠率(12.5%)比单纯输卵管因素患者(36.2%)明显降低,P<0.05;3种超排卵方案的临床妊娠率无统计学差异,P>0.05;卵巢囊肿穿刺术后确诊的EMs患者与非EMs单纯囊肿患者的治疗结局无统计学差异,P>0.05;EMs患者采用诱导排卵周期AIH的妊娠率(29.0%)明显高于自然周期(9.8%),P<0.05。结论:由于EMs引起不孕的机制复杂,EMs患者接受IVF/ICSI-ET治疗后的临床妊娠率明显低于单纯输卵管因素患者。EMs患者行AIH治疗时,建议采用诱导排卵方案。
Objective: To investigate the treatment outcomes of assisted reproductive technology (ART) in infertile women with endometriosis (EMs). Methods: Retrospective analysis of patients with EMs treated with ART at our center during 2006.01-2008.02. The treatment outcome was compared between EMs (n = 42, 48 cycles) and simple fallopian tube patients (n = 42, 42) who underwent IVF / ICSI- n = 1060,1211 cycles); patients with EMs using three superovulation regimens (n = 42, 42 cycles); patients with histologically confirmed EMs after ovarian cyst puncture (n = 16, 16 cycles ) Patients with non-EMs simple cysts (n = 79, 79 cycles); received artificial insemination (AIH) treatment with natural cycles (51 cycles) and induced ovulation cycles (31 cycles). Results: The clinical pregnancy rate (12.5%) in patients with EMs was significantly lower than that in patients with simple fallopian tube (36.2%) (P <0.05). There was no significant difference in clinical pregnancy rates between the three superovulation groups (P> 0.05) There was no significant difference in the outcome of patients with confirmed EMs and patients with non-EMs simple cysts (P> 0.05). The pregnancy rate (29.0%) in EMs patients with induced AIH was significantly higher than that of natural cycles (9.8%), P <0.05 . Conclusion: Due to the complicated mechanism of infertility caused by EMs, the clinical pregnancy rate of EMs patients receiving IVF / ICSI-ET is significantly lower than that of simple tubal factors. EMs patients undergoing AIH treatment, the proposed induction of ovulation program.