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目的研究卵巢刺激方案及血清CA125水平对手术后复发的卵巢子宫内膜异位囊肿不孕患者体外受精-胚胎移植(IVF-ET)治疗结果的影响。方法回顾分析2004年1月至2007年12月间经IVF治疗的39个周期(38例)卵巢子宫内膜异位囊肿手术后复发的不孕妇女治疗的临床结果,以及卵巢刺激方案与垂体降调后血清CA125水平间的相关性。结果长效促性腺激素释放激素激动剂(GnRH-a)垂体降调后采用短方案卵巢刺激13个周期,临床妊娠6个周期(46.2%);长方案卵巢刺激26个周期,临床妊娠8个周期(30.8%)。长方案组周期平均获卵数(8.42±5.22)显著高于短方案组(5.00±2.35)(P=0.021),但受精率、周期临床妊娠率组间无显著差异(P=0.482)。垂体降调后23个周期血清CA125为(18.5±12.6)U/ml;其中妊娠8例CA125为(10.2±5.8)U/ml,与妊娠结局呈显著负相关(r=-0.492,P=0.017)。结论卵巢子宫内膜异位囊肿术后复发的不孕妇女,垂体降调后作IVF有较好疗效。卵巢刺激短方案或长方案的妊娠结局无显著差异。降调后血清CA125水平可作为疗效的预测指标。
Objective To investigate the effects of ovarian stimulation and serum CA125 levels on the outcome of in vitro fertilization-embryo transfer (IVF-ET) in ovarian endometriosis patients with recurrent ovarian cysts. Methods The clinical results of infertile women with 39 cycles of ovarian endometriosis (39 cycles) treated with IVF from January 2004 to December 2007 were analyzed retrospectively. The results of ovarian stimulation and hypophysectomy Correlation of serum CA125 level after adjustment. Results Long-term gonadotropin-releasing hormone agonist (GnRH-a) pituitary decreased after short-term ovarian stimulation using 13 cycles, 6 cycles of clinical pregnancy (46.2%); long program of ovarian stimulation 26 cycles, clinical pregnancy 8 Cycle (30.8%). The mean number of oocytes retrieved in the long-term regimen group (8.42 ± 5.22) was significantly higher than that in the short-term regimen group (5.00 ± 2.35) (P = 0.021). However, there was no significant difference in fertilization rates and periodic clinical pregnancy rates (P = 0.482). Serum CA125 in 23 cycles after pituitary down-regulation was (18.5 ± 12.6) U / ml, among which 8 cases of CA125 in pregnancy were (10.2 ± 5.8) U / ml and had a significant negative correlation with pregnancy outcome (r = -0.492, ). Conclusion Infertility women with ovarian endometriosis recurrence after IVF have a good effect after pituitary down-regulation. There was no significant difference in the pregnancy outcome between the short-term or long-term ovarian stimulation. Decreased serum CA125 levels can be used as predictors of efficacy.