在试管婴儿之前,最大限度地治疗大型子宫内膜瘤 (≥4厘米):乙醇硬化疗法,囊切除术或不进行干预?
Yavuz Emre Şükür1,2, Necati Berk Kaplan3, Batuhan Aslan3,4
1Department of Obstetrics and Gynecology, School of Medicine, Ankara University, Cebeci Hastanesi, Dikimevi, Ankara, Türkiye. yesukur@gmail.com.
BMC women's health
|October 22, 2025
概括
乙醇硬化疗法 (EST) 在接受体外受精 (IVF) 的大型子宫内膜瘤妇女中显著提高了活产率. 与没有干预或囊切除术相比,EST提高了卵细胞产量,并保持了卵巢储备.
科学领域:
- 生殖医学 生殖医学
- 不孕症治疗 不孕症治疗
- 妇科外科手术 妇科外科
背景情况:
- 在体外受精 (IVF) 之前,大型子宫内膜瘤 (≥4厘米) 的最佳管理尚不清楚.
- 没有干预,乙醇硬化疗法 (EST) 和腹腔镜囊切除术的比较对于试管婴儿计划至关重要.
研究的目的:
- 为了比较试管婴儿前三种大型子宫内膜瘤管理策略的累积活产率 (CLBR).
- 评估二次结果,包括卵细胞产量,受精,植入和周期取消率.
主要方法:
- 对90名经过第一个试管婴儿周期 (2020-2023) 的不育妇女进行了回顾性队列研究.
- 组:没有干预 (N=39),EST (N=20),囊切除术 (N=31).
- 主要结局:每开始周期的CLBR;次要结局:卵细胞/胚胎产量,植入率,取消率.
主要成果:
- EST组显示显著更高的CLBR (65%) 与没有干预 (30.8%) 和囊切除术 (29%) (P=0.017).
- 与没有干预 (5.7±4.3) 和囊切除术 (4.2±3.5) (P<0.001) 相比,EST组的卵细胞产量更高 (10.1±3.9).
- EST保留了卵巢储备,没有显著的AMH变化;囊切除术的取消率最高 (35.5%).
结论:
- 在试管婴儿之前的乙醇硬化疗法改善了大型子宫内膜瘤的累积活产结果.
- EST增强了卵细胞产量,减少了周期取消,并保持了卵巢储备.
- 在患有大型子宫内膜瘤的患者中,EST是一种有利的IVF规划管理策略.
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