子宫内膜异位症合并不孕患者治疗后期待妊娠情况分析

目的 探讨子宫内膜异位症(endometriosis,EM)合并不孕患者治疗后妊娠情况.方法 总结184例EM合并不孕患者治疗后妊娠情况.按照1985年美国生育协会修订的内异症分期标准进行分期,其中Ⅰ期64例,Ⅱ期20例,Ⅲ期54例,Ⅳ期46例;并于腹腔镜下进行卵巢异位内膜病灶切除和粘连分解、盆腔腹膜异位内膜病灶电凝及...

The analysis of expectant pregnant after treatment of Endometriosis

Objective To analyze the pregnant results after treatment of Endometriosis (EM) complicated with infertility.Methods The pregnancyof 184 cases who were diagnosed as EM and infertility and underwent treatment were followed up from June 2003 to June 2008.The cases were divided into 4 groups according to the 1985 amendment of the American Fertility Society staging of endometriosis (r-AFS) for staging,in which 64 cases were in stage Ⅰ,20 patients were in stage Ⅱ,54 cases were in stage Ⅲ,46 cases were in stage Ⅳ.All cases were operated by laparoscopic removal of ovarian endometriotic lesions and adhesions decomposition,while the pelvic peritoneal endometriotic lesions and tubal coagulation liquid were treated withplastic surgery.The relation between the pregnant rate and time was analyzed according to the time interval from 1 to 12 months,13 to 24 months,25 to 36 months after operation.The factors of age,infertility type,the stage of EM were selected factors and the related factors of successful pregnancy were analyzed by multi-variate logistic regression.Results The overall pregnancy rate was 44.6%.The pregnancy rate of the first,second,third years after the laparoscopic surgery was 34.8%,11.7%,3.8%,which were significantly different(P<0.01).Age,infertility type and the stage of EM were analyzed in the logistic regression (P=0.283,0.986,0.018).However,the stage of EM was the only factor which was associated with the pregnant rate as shown by the logistic regression analysis.Patients with stage Ⅲ～Ⅳ EM did not shown higher pregnant rate even combined with adjuvant therapy(P>0.05).Conclusions Laparoscopic surgery can improve the pregnant rate of patients with EM complicated withinfertility.The pregnant rate of the first year after the surgery is the highest.The stage of EM is the only factor that may affect the pregnant rate and the adjuvant therapy can’t improve the pregnant rate.