子宫内膜异位症术后不孕患者129例分析(1)
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[摘要] 目的:研究子宫内膜异位症手术后不孕的患者的卵巢储备情况与妊娠情况。方法:回顾性分析927例门诊不孕症患者,其中手术后的子宫内膜异位症患者129例,与其他原因不孕患者比较卵巢储备功能情况,比较子宫内膜异位症中有无卵巢手术者卵巢储备的情况。并分析各期子宫内膜异位症患者的妊娠情况。结果:手术后子宫内膜异位症不孕患者的基础窦卵泡数明显少于其他原因不孕患者,有卵巢手术的子宫内膜异位症患者卵巢储备有下降的趋势,但差异无统计学意义。临床分期越后,子宫内膜异位症患者的妊娠率越低。结论:子宫内膜异位症手术特别是卵巢巧克力囊肿剔除对卵巢的储备有影响,术后应尽快受孕,必要时助孕治疗。
[关键词] 子宫内膜异位症;不孕;分析
[中图分类号] R711.71 [文献标识码]A [文章编号]1674-4721(2010)06(a)-046-02
Analysis of 129 cases of infertile patient post- operation of endometriosis
SHEN Dan
(People's Hospital of Wuchuan City,Guangdong Province, Wuchuan524500,China)
[Abstract] Objective: To study the ovarian reservation and pregnancy rate of infertility patients after surgery of endometriosis.Methods: 927 cases of infertile patient out clinic were analyzed retrospectively including 129 cases of post-operative patients with endometriosis. The ovarian reservation of the endometriosis patients was compared with the cases of other infertility causes. And the ovarian reserve was compared between the patients of endometriosis with or without ovarian cyst surgery.Moreover, the pregnancy rate of the patients at different stages was analyzed. Results: The number of antral follicle of the patients with endometriosis post-operation was significantly less than patients with other infertility causes. The ovarian reserve of patients with endometriosis ovarian cyst surgery trended to decline, but there was no significant difference.The pregnancy rate of the patients with endometriosis at late clinical stage was lower.Conclusion: Endometriosis, especially ovarian chocolate cyst removal surgery, has an impact on ovarian reserve. Patients with endometriosis should try to conceive as soon as possible after operation. When necessary, assisted reproductive treatment should be recommended.
[Key words] Endometriosis;Infertility;Analysis
子宫内膜异位症(EM)是常见的妇科疾病,其主要表现为盆腔疼痛和不孕[1]。有报道不孕患者中子宫内膜异位症患者占30%～58%[2]。手术治疗是子宫内膜异位症的主要治疗手段之一,而手术可能对患者卵巢储备有影响。本文对手术后子宫内膜异位症不孕患者的卵巢储备情况作分析。
1资料与方法
1.1一般资料
收集2008年1月～2009年12月门诊接诊的不孕症患者共927例,不孕原因包括:输卵管因素、排卵障碍、子宫内膜异位症、男方因素、不明原因不孕等。其中129例患者为子宫内膜异位症术后。
1.2 方法
子宫内膜异位症以手术诊断,按1985年美国生育协会修订的EM分期标准( r - AFS)进行分期[3],比较子宫内膜异位症的不孕患者卵巢储备情况以及妊娠情况 ......
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