子宫内膜异位症相关不孕症的体外受精和胚胎移植的结果:一项病例对照研究

Alfaina Wahyuni
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摘要

子宫内膜异位症不孕的病理生理学仍有争议,并被广泛研究。提出了几种机制。子宫内膜异位症的体外受精-胚胎移植(IVF-ET)方案是否能提高生育能力仍需进一步研究。目的:比较子宫内膜异位症与非子宫内膜异位症的IVF-ET输出量。方法:本研究采用病例对照设计的非实验研究。2017年对二手数据进行了回顾性研究。样本是50名子宫内膜不孕症患者和50名不孕症输卵管因子和/或精子,在日惹的Permata Hati诊所,Dr. Sardjito医院进行IVF-ET项目。结果:研究结果是受精率,即基于妊娠试验的若干优质胚胎和妊娠成功率。数据分析采用T检验和卡方统计检验。采用logistic回归进行多因素分析。两个研究组的特征相似:年龄、BMI、不孕持续时间、基础FSH、基础E2、刺激类型和促性腺激素需求。子宫内膜异位症组优质胚胎数较低(2.34±2.33 vs 3.44±2.97;p 0.259)。与非子宫内膜异位症相比,子宫内膜异位症组妊娠失败风险更大(OR 3.758;CI95% 1.1112.68;p < 0.03)。结论:子宫内膜异位症与非子宫内膜异位症受精率无明显差异。子宫内膜异位症组优质胚胎数量低于非子宫内膜异位症组。子宫内膜异位症组妊娠失败发生率高于非子宫内膜异位症组。
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The Outcomes of Invitro Fertilization and Embryo Transfer in Endometriosis-Associated Infertility: A Case Control Study
-The pathophysiology of infertility in endometriosis is still controversial and widely investigated. Several mechanisms are put forward. Whether In Vitro Fertilization-Embryo Transfer (IVF-ET) program in endometriosis is a solution to improve the fertility still needs further studied. Objective : To compare the output of IVF-ET between endometriosis infertility and that of non-endometriosis infertility. Methods : This research is non experimental research with case control design. A retrospective approach with secondary data was conducted in 2017. The samples are fifty endometrial infertility patients and fifty infertility tubal factor and or sperm undergoing IVF-ET program at Permata Hati Clinic, Dr. Sardjito Hospital Yogyakarta. Results : The research output is fertilization rate, i.e. a number of good quality embryo and the success of pregnancy based on pregnancy test. Data analysis was done by statistical test of T test and Chi Square. Multivariate analysis was done by logistic regression. Characteristics of both study groups are similar: in terms of age, BMI, duration of infertility, basal FSH, basal E2, stimulation type and gonadotropin needs. A number of good quality embryos in endometriosis group is lower (2.34 ± 2.33 vs 3.44 ± 2.97; p <0.039), but the fertilization rate is the same (48.58 ± 27.16 vs 55.19 ± 30.9; p > 0.259). Compared to non-endometriosis, endometriosis group has bigger risk of pregnancy failure (OR 3.758; CI95% 1.1112.68; p <0.03). Conclusion : There is no difference in fertilization rates between endometriosis and non-endometriosis. The number of good quality embryo on endometriosis group is lower than non-endometriosis. Pregnancy failure on endometriosis group is higher than non-endometriosis group.
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