不同方法治疗卵巢子宫内膜异位囊肿后行IVF-ET结局的比较

发布时间：2018-06-27 10:48

  本文选题：卵巢子宫内膜异位症 + 不孕症　； 参考：《华北理工大学》2015年硕士论文

【摘要】：目的通过对卵巢子宫内膜异位囊肿患者应用腹腔镜下囊肿剥除术和阴道超声引导下囊肿穿刺术治疗后行体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)的结局进行比较,探讨不同方法治疗卵巢子宫内膜异位囊肿后对不孕患者卵巢功能以及IVF-ET结局的影响。方法本研究为类实验性研究,对象为2013年1月至2014年12月在唐山市妇幼保健医院生殖遗传科接受IVF-ET治疗的卵巢子宫内膜异位囊肿因素的不孕症患者84例,其中包括A组:曾行腹腔镜下卵巢巧克力囊肿剥除术的术后患者52例,B组:临床上诊断为卵巢子宫内膜异位囊肿,经B超引导下囊肿穿刺的患者32例。两组患者均于术后3~12个月行IVF治疗。将两组患者的年龄、不孕年限、囊肿直径、月经第二天的窦卵泡数以及基础性激素六项水平、促排卵药物(Gn)用药总量、Gn使用天数、HCG注射日14mm以上的卵泡数、HCG注射日性激素六项水平、HCG注射日子宫内膜厚度、HCG注射日A型内膜比例、获卵数、移植胚胎数、冷冻胚胎数、受精率、优胚率、完成移植周期率、临床妊娠率以及流产率进行比较。结果1两组患者的年龄、不孕年限、囊肿直径比较,差异无统计学意义(P0.05)。2两组患者术后卵巢功能均降低,并且A组的窦卵泡数低于B组,A组的基础FSH水平和基础E2水平高于B组,差异有统计学意义(P0.05)。3两组患者的促排卵用药(Gn)用药天数和Gn用药总量相比较,差异无统计学意义(P0.05)。4 A组HCG注射当日14mm以上的卵泡个数和HCG注射当日血清E2水平均低于B组,差异有统计学意义(P0.05)。5 A组与B组的子宫内膜厚度、子宫内膜类型比较,差异无统计学意义(P0.05)。6 A组患者的获卵数低于B组,差异有统计学意义(P0.05),但两组患者MⅡ卵数差异无统计学意义(P0.05)。7 A组和B组的获得胚胎数、可移植胚胎数、冷冻胚胎数比较,差异无统计学意义(P0.05)。8两组患者受精率、优胚率比较,差异无统计学意义(P0.05)。9 A组患者的完成移植周期率和临床妊娠率与B组比较,差异无统计学意义(P0.05),但B组患者的流产率明显高于A组,差异有统计学意义(P0.05)。结论1腹腔镜下卵巢囊肿剥除术比阴道超声引导下卵巢囊肿穿刺术更易降低卵巢储备功能。2阴道超声引导下卵巢囊肿穿刺术后行IVF-ET的自然流产率偏高。3两种治疗方法妊娠率相近,患有卵巢子宫内膜异位囊肿的不孕妇女,可依据自身意愿选择治疗方式。
[Abstract]:Objective to compare the outcome of in vitro fertilization and embryo transfer (in vitro fertilization and embryo transfer IVF-ET after laparoscopic cystectomy and transvaginal ultrasound guided cysts puncture in patients with ovarian endometriosis. To investigate the effects of different methods on ovarian function and IVF-ET outcome in infertile patients. Methods from January 2013 to December 2014, 84 infertile women with ovarian endometriosis cyst factors received IVF-ET treatment in the Department of Reproductive Genetics of Tangshan Maternal and Child Health Hospital. Group A included 52 patients with ovarian chocolate cyst excision under laparoscope and group B: 32 patients were diagnosed as ovarian endometriosis cysts and 32 patients were punctured by B-ultrasound guided cysts. The patients in both groups were treated with IVF 3 ~ 12 months after operation. The age, length of infertility, cyst diameter, number of antral follicles on the second day of menstruation, and basic sex hormone levels were measured. The number of follicles above 14mm on the day of HCG injection, the endometrial thickness on the day of HCG injection and the proportion of type A endometrium on the day of HCG injection, the number of eggs obtained, the number of embryos transferred, the number of frozen embryos, the number of embryos obtained, the number of embryos transferred, and the number of frozen embryos on the day of HCG injection. Fertilization rate, embryo rate, complete transplant cycle rate, clinical pregnancy rate and abortion rate were compared. Results 1 there was no significant difference in age, infertility and cyst diameter between the two groups (P0.05). The number of antral follicles in group A was lower than that in group B (P 0.05), and the levels of basal FSH and E _ 2 in group A were significantly higher than those in group B (P0.05). There was no significant difference in the number of follicles above 14mm on the day of HCG injection in group A and the level of serum E2 on the day of HCG injection. The difference was statistically significant (P0.05). The thickness of endometrium and the type of endometrium in group A and group B were significantly lower than those in group B (P0.05). There was no significant difference (P0.05) between group A and group B (P0.05), but there was no significant difference in the number of eggs of M 鈪，

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