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目的分析不孕症合并子宫内膜异位症腹腔镜下治疗的妊娠结局及相关影响因素。方法选择2010年12月-2013年6月于该院行腹腔镜下手术治疗的不孕症合并子宫内膜异位症患者共计148例,观察统计患者术后妊娠情况以及妊娠结局,分析术后妊娠率与术后时间、年龄、不孕时间、不孕类型、r-AFS分期、病理分型、术后使用促性腺激素释放激素激动剂(GnRH-a)及术后使用促排卵药物治疗情况等临床因素的相关性以及r-AFS分期和术后使用GnRH-a治疗与妊娠结局的相关性。结果术后3年累积妊娠85例,妊娠率为57.4%,术后<1年的总妊娠率明显高于术后1年~和2~3年的总妊娠率,差异有统计学意义(χ~2=3.697、4.358,P<0.65),术后1年~的总妊娠率明显高于术后2~3年的总妊娠率,差异有统计学意义(χ~2=4.072,P<0.05);术后妊娠率在年龄(<35岁、≥35岁)、不孕时间(≤3年、>3年)、不孕类型(原发不孕、继发不孕)、术后使用促排卵药物治疗(是、否)等临床因素中比较差异有统计学意义(χ~2=3.816、2.935、2.963、2.679,P<0.05);术后妊娠率与r-AFS分期、病理分型、术后是否使用GnRH-a治疗无关,差异无统计学意义(χ~2=1.304、0.898、1.137,P>0.05);r-AFS分期与妊娠结局(良好结局、不良结局)无关,差异无统计学意义(χ~2=1.014,P>0.05);术后是否使用GnRH-a治疗与妊娠结局有显著相关性,差异有统计学意义(χ~2=3.856,P<0.05)。结论患者年龄、不孕时间、不孕类型、是否使用促排卵药物是影响不孕症合并子宫内膜异位症患者术后妊振率的相关因素;术后是否使用GnRH-a治疗是影响妊娠结局的相关因素。
Objective To analyze the pregnancy outcome and related factors of laparoscopic treatment of infertility with endometriosis. Methods A total of 148 cases of infertility with endometriosis undergoing laparoscopic surgery in our hospital from December 2010 to June 2013 were enrolled. A total of 148 cases of post-operative pregnancy and pregnancy outcomes were observed. Pregnancy rate and postoperative time, age, duration of infertility, type of infertility, r-AFS staging, pathological classification, postoperative use of gonadotropin-releasing hormone agonist (GnRH-a) and postoperative ovulation induction therapy And other clinical factors and r-AFS staging and postoperative GnRH-a treatment and pregnancy outcomes. Results The cumulative pregnancy rate in 3 years after operation was 85, with a pregnancy rate of 57.4%. The total pregnancy rate of <1 year after operation was significantly higher than that of 1 year ~ 2 years and 2 ~ 3 years after operation (χ ~ 2 = 3.697,4.358, P <0.65). The total pregnancy rate at 1 year after operation was significantly higher than that at 2 ~ 3 years after operation (χ ~ 2 = 4.072, P <0.05) ); The postoperative pregnancy rate in the age (35 years old, ≥ 35 years), infertility time (≤ 3 years,> 3 years), type of infertility (primary infertility, secondary infertility), postoperative use Ovarian drug treatment (yes, no) and other clinical factors were significantly different (χ ~ 2 = 3.816,2.935,2.963,2.679, P <0.05); postoperative pregnancy rate and r-AFS staging, pathological type, There was no significant difference between the two groups (χ ~ 2 = 1.304,0.898,1.137, P> 0.05). No correlation was found between r-AFS stage and pregnancy outcome (good outcome, bad outcome) (Χ ~ 2 = 1.014, P> 0.05). There was a significant correlation between postoperative GnRH-a treatment and pregnancy outcome (χ ~ 2 = 3.856, P <0.05). Conclusions Patients’ age, duration of infertility, type of infertility, ovulation induction or not are the related factors that influence the pregnancy rate of infertility patients with endometriosis; whether GnRH-a treatment affects pregnancy The outcome of the relevant factors.