子宫内膜非典型增生患者助孕策略分析

目的：探讨子宫内膜非典型增生患者经保守治疗满意后进行助孕的策略.方法：回顾性分析北大医院生殖中心接诊的4例经药物保守治疗满意后的子宫内膜非典型增生症患者病例资料.结果：4例患者诊断性刮宫病理诊断为不同程度的内膜非典型增生,其中2例同时诊断子宫内膜上皮内瘤变.患者不孕时间为8~120个月,根据情况分别进行了监测排卵、促排卵及IVF治疗,2例足月分娩,1例晚期流产,1例妊娠中.结论：子宫内膜非典型增生具有较高的复发率及恶变率.这类患者如有生育要求,无论是否达到不孕症的诊断标准,均应在保守治疗满意后积极协助其尽早妊娠.选择适当的助孕方式,帮助患者尽早妊娠,降低复发率.进行IVF治疗时,可考虑首选GnRHa超长方案降调节.

Assisted reproductive strategy analysis for endometrial atypical hyperplasia patients

Objectives： To discuss the strategy of assisted reproductive technologies after conservative treatment for endom- etrial atypical hyperplasia. Method： A retrospective case analysis of four endometrial atypical hyperplasia patients who were well treated with a conservative management from 2009 to 2012 were carefully conducted. Results： After dilatatiofi and curettage, all patients were pathologically diagnosed with atypical hyperplasia, and two of them with endometrial intraepithelial neoplasia. Infer tility periods of these patients were 8 to 120 months, and all four patients received assisted reproductive treatments, including in spection ovulation, ovulation induction and IVF. Two patients had term delivery, one got abortion at 22 weeks plus 6 days, and one was still in flint trimester of her pregnancy. Conclusion： Endometrial atypical hyperplasia has high risk of progressing to car- cinoma. Patients with an intention of delivery should use appropriate assisted reproductive technology to achieve an immediate pregnancy after fertility - sparing treatment as soon as possible even if they were not infertility patients. Although, there are no delinite recommendations, the prolonged gonadntropin - re]easing hormone （GnRH） agnnists＇ protocol could be taken as the first scheme for in Vitro Fertilization embryo Transfer.