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优化卵巢内膜瘤的不孕症治疗:在体外受精计划之前或之后,外科手术是最好的吗?

Ivan Sini^1,2,3,4, Aries Joe⁵, Nining Handayani⁶

¹Faculty of Medicine, IPB University, Bogor, Indonesia. ivan.sini@apps.ipb.ac.id.

Archives of gynecology and obstetrics

|March 5, 2025

概括

对于接受体外受精 (IVF) 的子宫内膜异位症和子宫内膜瘤妇女来说,在子宫内膜异位瘤手术 (IVF-OPS) 之前进行体外受精 (IVF) 与手术前 (OPS-IVF) 相比,改善了胚胎质量. 试管婴儿-OPS是获得更好的试管婴儿结果的一种突出的方法.

科学领域:

生殖医学生殖医学
妇科外科手术妇科外科
不孕症治疗不孕症治疗

背景情况:

子宫内膜异位症是生育年龄妇女常见的疾病,通常与不孕症有关.
卵巢内膜瘤是一种由子宫内膜异位症引起的卵巢囊,可以使体外受精 (IVF) 治疗复杂化.
进行试管婴儿的子宫内膜异位症与子宫内膜瘤的最佳管理策略对于改善妊娠率至关重要.

研究的目的:

评估不同临床管理策略对子宫内膜异位症与子宫内膜瘤对试管婴儿结果的影响.
将子宫内膜瘤手术 (IVF-OPS) 之前的试管婴儿和试管婴儿 (OPS-IVF) 之前的手术的疗效进行比较.
确定改善临床妊娠率和胚胎学结果的最突出的方法.

主要方法:

一项追溯的横截面受控研究,涉及86对患有子宫内膜异位症和子宫内膜瘤的夫妇进行试管婴儿.
患者被分为两组:IVF-OPS (手术前的IVF) 和OPS-IVF (试管婴儿前的手术).
对照组接受了没有去除子宫内膜瘤的试管婴儿. 临床怀孕率和胚胎细胞质量是主要结局. 统计分析包括曼-惠特尼,克鲁斯卡尔-瓦利斯和奇平方测试.

主要成果:

虽然临床怀孕率在各组之间是可比的 (p=0.068),但IVF-OPS组显示出高质量的胚胎囊数量显著增加 (p<0.05).
在临床怀孕率和胚胎实验室结果 (p<0.05) 方面,IVF-OPS表现优于OPS-IVF.
这项研究表明,IVF-OPS是具有子宫内膜瘤的子宫内膜症的更为突出的管理方法.

结论:

对于子宫内膜异位症与子宫内膜瘤的外科干预,当在体外受精计划后进行时,更有效.
试管婴儿-OPS策略在改善试管婴儿周期的成功方面具有优势,特别是在胚胎发育方面.
这一发现为管理子宫内膜异位症和子宫内膜瘤不育患者的临床医生提供了宝贵的见解.

关键词:

子宫内膜异位症是什么?子宫内膜异位症是什么在体外受精计划中的体外受精计划.不孕不育不孕不育不孕不育手术手术手术术术

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