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題名 | Poor Ovarian Response with High Cancellation Rate during Controlled Ovarian Hyperstimulation after Enucleation of Ovarian Endometriomas=子宮內膜異位瘤病患術後接受刺激排卵藥物有較差的卵巢反應 |
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作者姓名(中文) | 李國光; 何信頤; 張幸治; 林正凱; 蘇金琮; 胡玉銘; 林明輝; | 書刊名 | 臺灣婦產科醫學會會刊雜誌 |
卷期 | 42:2 2003.06[民92.06] |
頁次 | 頁85-90 |
分類號 | 417.27 |
關鍵詞 | 囊腫摘除術; 卵巢功能; 子宮內膜異位瘤; Cystectomy; Endometrioma; Ovarian reserve; |
語文 | 英文(English) |
中文摘要 | 目的:評估手術摘除子宮內膜異位瘤後,病人接受刺激排卵藥物時的卵巢反應。方法:我們回溯研究自1992年1月至1999年12月之間在本院接受試管嬰兒治療的病患。其中以年齡40歲以下,且接受子宮內膜異位瘤摘除手術後仍未懷孕而進行試管嬰兒治療的病人為第一組,有51位病人共接受71次試管嬰兒治療; 第二組為男性不孕症接受卵細胞質內單一精蟲注射的病人,以此做為對照組,有48位病人共接受52次試管嬰兒治療。我們比較這兩組的取卵取消率及卵巢反應。結果:第一組病人的取卵取消率比第二組高(28.2%比7.7% , P<0.05)。且第一組病人在注射HCG當天的E2值和主濾泡數目、成熟卵子數目及胚胎數目都明顯較低下。但是臨床懷孕率(32.0%比42.6%)、著床率(13.1%比15.1% ) 及活產率(30.0%比31.9%)則沒有統計學上差異。結論:子宮內膜異位瘤接受摘除手術後會傷害到卵巢的功能,在卵巢刺激後會有較高的取卵取消率及較差的卵巢反應。 |
英文摘要 | Objective: To evaluate ovarian response during controlled ovarian hyperstimulation (COH) in patients with endometriomas previously treated surgically. Material(s) and Method(s): The medical records of patients under 40 years old undergoing IVF from January 1992 to December 1999 were retrospectively reviewed. In group 1 (51 patients, 71 cycles), all patients had undergone cystectomy for ovarian endometriomas prior to IVE. A control group 2 (48 patients, 52 cycles) had had male factor infertility and had undergone ICSI. The ovarian response and cancellation rates of these two groups during COH were compared. Result(s): The cancellation rate in group 1 was significantly higher than in group 2 (28.2% vs. 7.7%, P<0.05). The estradiol level and number of dominant follicles on the day of hCG injection, the number of mature oocytes retrieved, and the number of embryos available were all significantly lower in group 1. There were no statistical differences in the clinical pregnancy rate (32.0% vs. 42.6%), implantation rate (13.1% vs. 15.1%) or live birth rate (30.0% vs. 31.9%). Conclusion(s): Ovarian surgery may damage ovarian reserve, resulting in poor ovarian response and increased cancellation rate during COH. |
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