在经过手术腹腔镜检查后患有中度和重度子宫内膜异位症的妇女中,自发受孕的预测因素:一项队列研究
Nivedita Gupta1, Treasa Joseph1, Reka Karuppusami2
1Department of Reproductive Medicine and Surgery, Christian Medical College, Vellore, India.
概括
子宫内膜异位症生育指数 (EFI) 准确地预测了在进行生育增强手术后患有中度至重度子宫内膜异位症的女性的怀孕率. 较高的EFI得分与明显更好的自发妊娠结果相关,有助于临床决策.
科学领域:
- 生殖医学 生殖医学
- 妇科 妇科医生 妇科
- 手术创新 在外科创新.
背景情况:
- 子宫内膜异位症显著影响生育能力,需要可靠的预后工具.
- 微创手术为中度至重度子宫内膜异位症的妇女提供提高生育能力的选择.
- 对各种人群来说,生育预测得分的外部验证至关重要.
研究的目的:
- 在南亚人口中对子宫内膜异位症生育指数 (EFI) 进行外部验证.
- 评估子宫内膜异位症增生微创手术后的累积自发妊娠率.
- 确定影响晚期子宫内膜异位症妇女怀孕结果的因素.
主要方法:
- 在第三级不孕症治疗中心进行了回顾性队列研究.
- 包括患有r-ASRM第3或第4期子宫内膜异位症的妇女,接受节育性最小侵入性腹腔镜检查.
- 基于EFI分数和临床因素的自发怀孕率的分析.
主要成果:
- 具有较高EFI评分 (7-8) 的女性,与较低评分 (0-3,17%在3年) 的女性相比,具有显著更高的累积自发怀孕率 (84.5%在3年).
- 自发怀孕的负面预测因素包括较低的腹毛囊数量,较晚的母亲和父亲年龄,以及较低的最小功能得分.
- 囊切除术与手术后自发怀孕有积极的关联,观察到总体怀孕率为37.3%.
结论:
- 子宫内膜异位症生育指数 (EFI) 在南亚人口中得到验证,与手术后的怀孕率有很好的相关性.
- 临床因素,如腹卵泡数量低和父亲年龄较高,是术后生育咨询的重要考虑因素.
- EFI和确定的临床因素有助于为想要怀孕的晚期子宫内膜异位症妇女做出知情决策.
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