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目的:探讨体外受精(IVF)或卵泡浆内单精子注射(ICSI)周期中的子宫内膜异位症(EMS)患者临床结局的影响因素。方法:回顾性分析了2011年1月~2013年3月在北京大学深圳医院生殖医学科接受IVF或(和)ICSI治疗的321例患者,将其分为EMS组(143例)和排除EMS的对照组(178例),根据妊娠结局再将两组分为妊娠组和未妊娠组,对异位症组和对照组的妊娠和未妊娠组临床资料进行总结。结果:1EMS患者妊娠组与未妊娠组相比,基础窦卵泡数增多,Gn用量减少,而h CG日E2水平、获卵数、移植及冷冻胚胎数均增加,有统计学差异(P<0.05)。对照组的妊娠组与未妊娠组的上述指标均无统计学差异(P>0.05);EMS患者妊娠组与未妊娠组相比,体重指数(BMI)升高,有统计学差异〔(20.72±2.41)kg/m2vs(19.86±1.96)kg/m2,P<0.05〕。对照组的妊娠组与未妊娠组的BMI无统计学差异〔(21.33±2.52)kg/m2vs(21.39±2.99)kg/m2,P>0.05〕。2EMS妊娠组与对照组妊娠组的窦卵泡数、Gn用量、h CG日E2水平、获卵数、移植胚胎数、冷冻胚胎数、BMI差异无统计学意义(P>0.05)。3EMS未妊娠组与对照组未妊娠组相比冷冻胚胎数减少,BMI下降,余指标差异均无统计学意义(P>0.05)。结论:IVF助孕成功妊娠的EMS患者卵巢反应性较好,BMI较高,EMS患者的卵巢反应性是影响患者助孕结局的重要因素。
Objective: To investigate the influencing factors of clinical outcomes in patients with endometriosis (EMS) in in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles. Methods: A retrospective analysis of 321 patients receiving IVF or (and) ICSI in the Reproductive Medicine Department of Peking University Shenzhen Hospital from January 2011 to March 2013 was divided into EMS group (143 cases) and EMS The control group (178 cases), according to the pregnancy outcome, the two groups were divided into pregnancy group and non-pregnancy group. The clinical data of pregnancy group and non-pregnancy group of ectopic group and control group were summarized. Results: The number of basal antral follicles and the amount of Gn in pregnancy group were significantly lower than those in non-pregnancy group (P <0.05), while E2 level, number of oocytes retrieved, number of transplanted and frozen embryos were increased on h CG day ). There was no significant difference between the control group and the non-pregnant group (P> 0.05). Compared with the non-pregnant group, the body mass index (BMI) in the EMS group was significantly increased [(20.72 ± 2.41) kg / m2 vs (19.86 ± 1.96) kg / m2, P <0.05〕. There was no significant difference in BMI between control group and non-pregnant group [(21.33 ± 2.52) kg / m2 vs (21.39 ± 2.99) kg / m2, P> 0.05). There were no significant differences in the number of antral follicles, Gn dosage, E2 level on h CG day, number of oocytes retrieved, number of embryos transferred, number of frozen embryos and BMI in pregnancy group and control group (P> 0.05). The number of frozen embryos and the decrease of BMI in 3EMS non-pregnant group and control group were not statistically significant (P> 0.05). Conclusion: The ovarian response in EMS patients with IVF pregnancy-assisted pregnancy is better and the BMI is higher. The ovarian response in EMS patients is an important factor affecting the outcome of pregnancy.