子宫内膜异位症合并不孕患者行体外受精-胚胎移植术效果分析

目的：分析体外受精．胚胎移植术（IVF—ET）对子宫内膜异位症合并不孕病人的疗效，探讨影响其疗效的相关因素。方法：对本中心2003年1月至2008年6月176例（206周期）进行IVF—ET的病人作回顾性分析。研究组为子宫内膜异位症合并不孕病人83例102个周期，其中Ⅰ、Ⅱ期患者46例（57周期）作为A组，Ⅲ、Ⅳ期患者37例（45周期）作为B组，对照组为输卵管因素不孕病人93例104周期。比较3组病人FSH用量、子宫内膜厚度、获卵数、受精率、种植率、妊娠率、流产率及异位妊娠率。结果：研究组中A、B组FSH用量[（2576．62±679．5）IU，（2687．22±695．76）IU]均大于对照组（2352．03±673．51）IU其获卵数[（10．92±4．94）个，（9．80±4．65）个]、受精率[（75．34±22．54）％，（73．90±23．25）％]均小于对照组[（获卵数（14．24±6．65）个，受精率（78．53±21．34）％]（P〈0．05），而子宫内膜厚度、妊娠率、种植率、流产率、异位妊娠率3组比较差异无显著性。结论：子宫内膜异位症合并不孕患者的卵巢储备功能相对较低，子宫内膜异位症的存在可能影响卵子质量、卵子发育及受精过程，而对IVF—ET妊娠率影响不明显。

Analysis of Effects of IVF-ET on Infertile-patients with Endometriosis

Objective： Analyzed the efficacy of in vitro fertilization and embryo transfer （IVF-ET） on endometriosis-associated infertilities to explore the related factors that influence the effects of IVF-ET on the patients. Methods：A retrospective study was conducted on 176 patients （206 cycles） regarding the outcomes of undergoing IVF- ET in our center from January 2003 to June 2008. The study group included 83 patients （102cycles） with endometriosis-associated infertility,46 patients in stage Ⅰ ,Ⅱ （57 cycles）as group A,37 patients in stage Ⅲ, Ⅳ （45 cycles） as group B. The control group included 93 infertile patients （ 104 cycles） with tubal disease. Compare the total used dose of FSH, the endometrium thickness, the number of oocytes, fertilization rate, implantation rate, pregnancy rate, abortion rate and ectopic pregnancy rate of the three groups. Results： The used dose of FSH of the group A（2 576.62 ± 679.5） and B （2 687.22 ± 695.76 ） were more than that of the control group （ 2 352 ± 673.51 ）, the oocytes retrieved（ 10.92 ±4.94,9.80±4.65 ） and the fertilization rate（75.34± 22.54,73.90 ± 23.25 ） were lower than that of control group（ oocytes retrieved： 14.24 ± 6.65, fertilization rate ： 78.53 ± 21.34 ） （ P 〈 0.05 ）. There was no difference in the endometrium thickness, pregnancy rate, implantation rate, abortion rate and ectopic pregnancy rate of the three groups. Conclusions： Endometriosis has no obvious effect on implantation. The impact of ectopic endometruim on the process of fertilize is one of the mechanism that cause infertility.