本文選題：卵巢子宮內(nèi)膜異位癥 + 不孕癥�。� 參考：《華北理工大學(xué)》2015年碩士論文

【摘要】：目的通過對(duì)卵巢子宮內(nèi)膜異位囊腫患者應(yīng)用腹腔鏡下囊腫剝除術(shù)和陰道超聲引導(dǎo)下囊腫穿刺術(shù)治療后行體外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)的結(jié)局進(jìn)行比較,探討不同方法治療卵巢子宮內(nèi)膜異位囊腫后對(duì)不孕患者卵巢功能以及IVF-ET結(jié)局的影響。方法本研究為類實(shí)驗(yàn)性研究,對(duì)象為2013年1月至2014年12月在唐山市婦幼保健醫(yī)院生殖遺傳科接受IVF-ET治療的卵巢子宮內(nèi)膜異位囊腫因素的不孕癥患者84例,其中包括A組:曾行腹腔鏡下卵巢巧克力囊腫剝除術(shù)的術(shù)后患者52例,B組:臨床上診斷為卵巢子宮內(nèi)膜異位囊腫,經(jīng)B超引導(dǎo)下囊腫穿刺的患者32例。兩組患者均于術(shù)后3~12個(gè)月行IVF治療。將兩組患者的年齡、不孕年限、囊腫直徑、月經(jīng)第二天的竇卵泡數(shù)以及基礎(chǔ)性激素六項(xiàng)水平、促排卵藥物(Gn)用藥總量、Gn使用天數(shù)、HCG注射日14mm以上的卵泡數(shù)、HCG注射日性激素六項(xiàng)水平、HCG注射日子宮內(nèi)膜厚度、HCG注射日A型內(nèi)膜比例、獲卵數(shù)、移植胚胎數(shù)、冷凍胚胎數(shù)、受精率、優(yōu)胚率、完成移植周期率、臨床妊娠率以及流產(chǎn)率進(jìn)行比較。結(jié)果1兩組患者的年齡、不孕年限、囊腫直徑比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。2兩組患者術(shù)后卵巢功能均降低,并且A組的竇卵泡數(shù)低于B組,A組的基礎(chǔ)FSH水平和基礎(chǔ)E2水平高于B組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3兩組患者的促排卵用藥(Gn)用藥天數(shù)和Gn用藥總量相比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。4 A組HCG注射當(dāng)日14mm以上的卵泡個(gè)數(shù)和HCG注射當(dāng)日血清E2水平均低于B組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。5 A組與B組的子宮內(nèi)膜厚度、子宮內(nèi)膜類型比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。6 A組患者的獲卵數(shù)低于B組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),但兩組患者M(jìn)Ⅱ卵數(shù)差異無統(tǒng)計(jì)學(xué)意義(P0.05)。7 A組和B組的獲得胚胎數(shù)、可移植胚胎數(shù)、冷凍胚胎數(shù)比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。8兩組患者受精率、優(yōu)胚率比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。9 A組患者的完成移植周期率和臨床妊娠率與B組比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05),但B組患者的流產(chǎn)率明顯高于A組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論1腹腔鏡下卵巢囊腫剝除術(shù)比陰道超聲引導(dǎo)下卵巢囊腫穿刺術(shù)更易降低卵巢儲(chǔ)備功能。2陰道超聲引導(dǎo)下卵巢囊腫穿刺術(shù)后行IVF-ET的自然流產(chǎn)率偏高。3兩種治療方法妊娠率相近,患有卵巢子宮內(nèi)膜異位囊腫的不孕婦女,可依據(jù)自身意愿選擇治療方式。
[Abstract]:Objective to compare the outcome of in vitro fertilization and embryo transfer (in vitro fertilization and embryo transfer IVF-ET after laparoscopic cystectomy and transvaginal ultrasound guided cysts puncture in patients with ovarian endometriosis. To investigate the effects of different methods on ovarian function and IVF-ET outcome in infertile patients. Methods from January 2013 to December 2014, 84 infertile women with ovarian endometriosis cyst factors received IVF-ET treatment in the Department of Reproductive Genetics of Tangshan Maternal and Child Health Hospital. Group A included 52 patients with ovarian chocolate cyst excision under laparoscope and group B: 32 patients were diagnosed as ovarian endometriosis cysts and 32 patients were punctured by B-ultrasound guided cysts. The patients in both groups were treated with IVF 3 ~ 12 months after operation. The age, length of infertility, cyst diameter, number of antral follicles on the second day of menstruation, and basic sex hormone levels were measured. The number of follicles above 14mm on the day of HCG injection, the endometrial thickness on the day of HCG injection and the proportion of type A endometrium on the day of HCG injection, the number of eggs obtained, the number of embryos transferred, the number of frozen embryos, the number of embryos obtained, the number of embryos transferred, and the number of frozen embryos on the day of HCG injection. Fertilization rate, embryo rate, complete transplant cycle rate, clinical pregnancy rate and abortion rate were compared. Results 1 there was no significant difference in age, infertility and cyst diameter between the two groups (P0.05). The number of antral follicles in group A was lower than that in group B (P 0.05), and the levels of basal FSH and E _ 2 in group A were significantly higher than those in group B (P0.05). There was no significant difference in the number of follicles above 14mm on the day of HCG injection in group A and the level of serum E2 on the day of HCG injection. The difference was statistically significant (P0.05). The thickness of endometrium and the type of endometrium in group A and group B were significantly lower than those in group B (P0.05). There was no significant difference (P0.05) between group A and group B (P0.05), but there was no significant difference in the number of eggs of M 鈪，

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