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主题:[转帖]子宫内膜异位症III/IV期患者术后接受体外受精/胞浆内单精子注射的时间间隔对于结果的影响

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[转帖]子宫内膜异位症III/IV期患者术后接受体外受精/胞浆内单精子注射的时间间隔对于结果的影响  发帖心情 Post By:2011/6/22 15:19:00

Effect of interval after surgery on in vitro fertilization/
intracytoplasmic sperm injection outcomes in patients
with stage III/IV endometriosis
子宫内膜异位症III/IV期患者术后接受体外受精/胞浆内单精子注射的时间间隔对于结果的影响

Keywords: endometriosis; infertility; fertilization in vitro; surgery
关键词:子宫内膜异位,不孕,体外受精,外科手术

Background For patients with severe endometriosis, the spontaneous pregnancy rates have been reported to be near 0 due to extreme distortion of normal pelvic anatomy. Surgery is one of the treatment options; however, if patients failed to conceive after surgery, in vitro fertilization (IVF) is effective. The objective of this retrospective study was to determine the clinical characteristics of IVF/ intracytoplasmic sperm injection (ICSI) in patients with stage III/IV endometriosis, and to determine the impact of the interval from surgery to IVF/ICSI on outcome.
背景:子宫内膜异位患者由于其极度扭曲的盆腔解剖结构,在所知的报道中其自然怀孕的概率几乎0。外科手术是一种治疗的选择,因此患者在外科手术失去效用后,体外受精还是有效的。这篇文章,只要是回顾体外受精/浆内单精子注射对子宫内膜异位III/IV期患者的效果,并了解影响体外受精/浆内单精子注射的时间间隔。

Methods One hundred and sixty patients who were diagnosed with stage III/IV endometriosis underwent IVF /ICSI cycles between February 2004 and June 2009 were enrolled. The mean interval from surgery to IVF, number of oocytes retrieved, fertilization rate, implantation rate, embryos transferred, and good embryos transferred were compared between two age groups (≤35 years and > 35 years).
方法:在2004年2月到2009年6月登记的160名子宫内膜异位III/IV期并接受过体外受精/浆内单精子注射的患者。体外受精的间隔时间,取出的卵母细胞数量,受孕率,着床率,胚胎移植,两个年龄段良好胚胎移植比较(≤35岁和≥35岁。)

Results The mean interval from surgery to IVF was (37.9±28.9) months for the group ≤ 35 years of age and (57.6±39.7) months for the group >35 years of age. Twenty-five IVF/ICSI cycles (12.8%) were performed during the first year after surgery, and 34.9% IVF/ICSI cycles were performed 2 years after surgery. No significant differences existed between the two groups with respect to the fertilization rate, implantation rate, number of embryos transferred, number of good embryos, clinical pregnancy rates, live birth rates, and cumulative clinical pregnancy rates (P >0.05). The probability of cumulative clinical pregnancies was 75%, 50%, and 25% ((29.0±4.8), (61.0±7.6), and (120.0±16.9) months after surgery, respectively).
结果:≤35岁组的体外受精间隔期间是37.9±28.9个月,≥35岁组的体外受精间隔期间是57.6±39.7个月。25个体外受精/浆内单精子注射周期(12.8%)会在手术后第一年进行,34.9%的体外受精/浆内单精子注射周期会在手术后第二年进行。在受孕率,着床率,胚胎移植数量,良好胚胎的数量,临床受孕率,出生率,累计临床妊娠率(P>0.05)方面不存在显著差异。在术后,累计临床妊娠率分别为75%,50%,和25%(29.0±4.8),(61.0±7.6),(120.0±16.9)个月。

Conclusions For infertile patients with stage III/IV endometriosis, the optimal time to conceive by IVF/ICSI is <2 years after surgery; nevertheless, most of the patients took a longer time to conceive
结论:对于那些患有子宫内膜异位III/IV期的不孕患者,最佳的体外受精/浆内单精子注射时间是在术后两年内受孕,然后,很多患者却选择在更久的时间后受孕。

endometriosis is one of the most challenging diseases for gynecologists who treat infertile women. The incidence of endometriosis in women with subfertility ranges from 20%–30%. For patients with severe endometriosis, the spontaneous pregnancy rates have been reported to be near 0% due to distortion of normal pelvic anatomy.1 Thus, surgery is one of the options to improve fecundity.2 If patients fail to conceive after surgery, in vitro fertilization (IVF) is an effective treatment option.1 In patients with endometriosis-associated infertility, surgery followed by IVF–ET is more effective than surgery alone.3 In practice, the interval from surgery to IVF varies greatly, and is determined by various factors, such as the
expectation for children, the economic burden and tubal patent condition. Whether or not the interval of time after surgery will influence the success rate of IVF is of clinical importance. In this retrospective study, we determined whether or not the interval from surgery to IVF had an influence on IVF outcome of infertile patients with stage III/IV endometriosis, and discuss the role of the physician in counseling patients after surgery.
对治疗不孕妇女的妇科医生来说,子宫内膜异位是最具挑战性(最复杂的)病症之一。子宫内膜异位造成妇女生育能力低下的概率很高,大约在20%~30%之间。子宫内膜异位患者由于盆腔骨骼及其扭曲,在所知的报道中其自然受孕率接近0%。因此手术是改变生育能力的一种选择。如果手术失败,体外受精是另一种有效的治疗方式。子宫内膜性不孕患者来说,术后进行体外受精和胚胎移植比单一手术治疗更有效。在实践中,由于各种因素的影响,从手术到体外受精的间隔比较大,例如对孩子的期望,经济负担和输卵管先天条件。术后间隔时间的长短将会影响体外受精成功率,这具有非常重要的临床意义。在这次回顾研究中,我们发现,术后和体外受精之间的间隔对子宫内膜异位III/IV期不孕患者体外受精结果又影响,并以医生的角色讨论病人术后的指导。


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[转帖]子宫内膜异位症III/IV期患者术后接受体外受精/胞浆内单精子注射的时间间隔对于结果的影响








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