超长方案用于子宫内膜异位症合并不孕者的体外受精-胚胎移植

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目的:比较不同分期的子宫内膜异位症(EMs)合并不孕妇女采用超长GnRH-a降调节方案进行体外受精-胚胎移植(IVF-ET)助孕治疗的结局。方法:回顾性分析以超长方案降调节行IVFET助孕卵巢储备功能正常的233例EMs合并不孕患者不同EMs分期的治疗结局,按EMs分期分为A组(I~II期,102例)和B组(III~IV期,131例)。结果:①患者年龄、平均手术次数、基础FSH(bFSH)等组间无统计学差异(P>0.05)。B组有卵巢内膜异位囊肿手术史的比例明显高于A组(P<0.01)。②促性腺激素(Gn)启动日及hCG注射日性激素、Gn使用剂量及天数、获卵数、受精率、卵裂率、可移植胚胎数等组间均无统计学差异(P>0.05)。③周期取消率、临床妊娠率、种植率、流产率等组间无统计学差异(P>0.05),移植周期活产率组间相似(60.64%vs 62.18%)(P>0.05)。结论:在卵巢储备功能正常的前提下,EMs合并不孕者采用超长方案降调节实施IVF-ET助孕的结局不受EMs分期的影响。 OBJECTIVE: To compare the outcomes of IVF-ET assisted pregnancy in women with endometriosis (EMs) and infertility with different stages of GnRH-a down-regulation regimen. Methods: A total of 233 EMs with infertility were enrolled in this study. The clinical outcomes of different stages of EMs staging were retrospectively analyzed. Group A (n = 102) And group B (stage III-IV, 131 cases). Results: ① There was no significant difference in age, average number of operations and basal FSH (PFS) between the two groups (P> 0.05). The proportion of surgical history of ovarian endometriosis in group B was significantly higher than that in group A (P <0.01). (2) There was no significant difference in the dosages and days of Gn, the number of oocytes retrieved, the rate of fertilization, cleavage rate and the number of transferable embryos between the start-up day of gonadotropin (Gn) and hCG injection of sex hormones. ③ There was no significant difference in cycle cancellation rate, clinical pregnancy rate, implantation rate and miscarriage rate between the two groups (P> 0.05). The rate of live births was similar between the two groups (60.64% vs 62.18%) (P> 0.05). Conclusions: Under the premise of normal ovarian reserve function, the outcome of IVF-ET assisted pregnancy is not affected by the staging of EMs.
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