腹腔镜卵巢内膜异位囊肿剥除术后卵巢低反应体外受精-胚胎移植的结局  

Outcome Analysis of in vitro Fertilization-embryo Transfer in Patients With Ovarian Endometrial Cyst Combined With Poor Ovarian Response After Laparoscopic Cystectomy

作　　者：单学敏[1] 席思思[1] 尚鶄[1] 杨秀丽[1] 薛晴[1] Shan Xuemin;Xi Sisi;Shang Jing(Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China)

机构地区：[1]北京大学第一医院妇产科,北京100034

出　　处：《中国微创外科杂志》2022年第2期114-118,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：国家自然科学基金重大研发计划培育项目(91949113)。

摘　　要：目的比较腹腔镜卵巢子宫内膜异位囊肿(ovarian endometrial cyst,OEC)剥除术后卵巢低反应(poor ovary response,POR)与OEC未手术POR体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)的结局。方法回顾性分析2013年1月~2018年12月我科103例POR行IVF-ET的临床资料,其中72例OEC术后POR(OEC术后组),31例OEC未手术POR(OEC组),比较2组获卵数、成熟卵母细胞(MⅡ卵母细胞)数、优质胚胎数、临床妊娠率、活产率的差异。结果OEC术后组获卵数较OEC组明显减少[2(1,3)个vs.3(2,4)个,Z=-2.297,P=0.022],MⅡ卵母细胞数显著减少[1(1,2)个vs.2(1,3)个,Z=-2.130,P=0.033],优质胚胎数显著减少[0(0,1)个vs.1(0,2)个,Z=-2.000,P=0.045]。2组临床妊娠率[17.6%(6/34)vs.27.8%(5/18),χ^(2)=0.244,P=0.621]、活产率[8.8%(3/34)vs.16.7%(3/18),χ^(2)=0.149,P=0.699]差异无显著性。OEC术后组早期流产率33.3%(2/6),OEC组20.0%(1/5)。结论腹腔镜OEC剥除术后POR患者IVF-ET结局不良。Objective To compare outcomes of in vitro fertilization-embryo transfer(IVF-ET)in patients with ovarian endometrial cyst(OEC)combined with poor ovarian response(POR)after laparoscopic cystectomy and patients with OEC without operation.Methods This retrospective study included 103 patients with POR who underwent IVF-ET in our department from January 2013 to December 2018.Among them,72 cases were OEC postoperative POR(OEC postoperative group)and 31 cases were OEC unoperated POR(OEC group).The differences in the number of retrieved oocytes,MⅡoocytes,high quality embryos,clinical pregnancy rate,early abortion rate and live birth rate between the two groups were compared.Results The number of retrieved oocytes in the OEC postoperative group was lower,and the difference was statistically significant[2(1,3)vs.3(2,4),Z=-2.297,P=0.022].The number of MⅡoocytes significantly decreased[1(1,2)vs.2(1,3),Z=-2.130,P=0.033].The number of high quality embryos significantly decreased[0(0,1)vs.1(0,2),Z=-2.000,P=0.045].There was no significant difference in clinical pregnancy rate[17.6%(6/34)vs.27.8%(5/18),χ^(2)=0.244,P=0.621]and live birth rate[8.8%(3/34)vs.16.7%(3/18),χ^(2)=0.149,P=0.699]between the two groups.The early abortion rate was 33.3%(2/6)in the OEC postoperative group and 20.0%(1/5)in the OEC group.Conclusion Patients with poor ovarian response after laparoscopic ovarian endometrioma cystectomy has a poor IVF-ET outcome.

关 键 词：卵巢低反应 腹腔镜卵巢子宫内膜异位囊肿剥除术 卵巢子宫内膜异位囊肿 体外受精-胚胎移植 妊娠结局 

分 类 号：R71[医药卫生—妇产科学]