| PurposeEndometriosis(EMs)is an estrogen dependent disease.Its main clinical symptoms include pelvic pain,menstrual aggravation,sexual intercourse pain and so on.EMS is also one of the main causes of infertility.Laparoscopic surgery can reduce the pain of patients and effectively remove the focus,but the pregnancy rate of patients with EMS infertility is still not ideal.The purpose of this study is to explore the factors that affect the natural pregnancy rate of patients with endometriosis(EMs)related infertility after laparoscopic surgery.Through the analysis of 1-year pregnancy rate and related factors that may affect the pregnancy rate of patients with EMS infertility after laparoscopic treatment,The factors that affect the pregnancy rate of Ems patients after laparoscopic surgery in 12 months include age,infertility time limit,previous pelvic surgery history,whether to accept postoperative assisted reproduction,r-AFS stage.Materials and methodsData source: a retrospective analysis was made of 200 patients with EMS infertility diagnosed preoperatively in the Department of gynecology and obstetrics,the First Affiliated Hospital of Zhengzhou University,who were treated by laparoscopy from March 2015 to March 2018.After the operation,a follow-up survey was conducted to analyze the pregnancy status.The pregnancy outcome was not confirmed by the criteria of the presence of pregnancy sac in the uterine cavity and the positive h CG in blood or urine [8] In consideration of the scope of the study,the occurrence of fetal arrest,abortion and other conditions in the course of pregnancy are classified as the scope of pregnancy.According to the evaluation results,the influence of different factors on the cumulative pregnancy rate of 12 months after operation was analyzed by single factor t test,chi square analysis and multiple linear regression.The end time of follow-up was May 31,2019.Observation indexes: statistical data of patients’ demography(age,body mass index,education background);intraoperative conditions: clinical characteristics,RAFS stage of American Society of reproductive medicine,focus distribution characteristics(ovarian type,peritoneal type,deep infiltration type),focus distribution characteristics of egg nest;previous history(infertility time limit,previous pelvic surgery history,whether severe dysmenorrhea Types of infertility);and postoperative pregnancy(natural pregnancy in one year,whether to accept assisted reproductive therapy)and so on,to analyze the correlation between the cumulative pregnancy rate of 12 months and the above factors.3.Statistical method: SPSS 27.0 statistical software was used for statistical analysis.T test was used for the comparison of measurement data between the two groups,chi square test was used for the comparison of classification data,multivariate linear regression analysis was used for the comprehensive analysis of multiple factors,with P = 0.05 as the test level and P <0.05 as the difference with statistical significance.Result91 patients(45.50%)were younger than 35 years old,109 patients(54.50%)were older than 35 years old,the mean body mass index(BMI)was(22.48 ± 1.96)kg/ m2,there were 149 successful pregnancies,30(20.13%)in 6 months,119(79.87%)in 6-12 months,140(70.00%)with college degree or above,unilateral and bilateralovarian diseases 98 cases(43.80%)and 102 cases(56.20%),58 cases(29.00%)in stage I,59 cases(29.50%)in stage II,55 cases(27.50%)in stage III,28 cases(14.00%)in stage IV,and the pregnancy rates in 12 months after operation were74.14%(43 / 58),66.10%(39 / 59)and 41.82%(23 / 55),respectively;133 cases(66.50%)of ovarian type and 133 cases(66.50%)of peritoneum type 51 cases(25.50%),16 cases(8.00%)were of deep infiltration type;115 cases(57.50%)had less than 3 years of infertility,85 cases(42.50%)had more than 3 years of infertility;121 cases(60.50%)had primary infertility;79 cases(40.50%)had secondary infertility;169 cases(83.06%)had severe dysmenorrhea;65 cases(47.52%)had previous pelvic operation history;49 cases(24.50%)received assisted reproduction.Among the patients included in the study,30 patients were treated with Gn RH-a for3-6 cycles to prevent postoperative recurrence.The age(P = 0.00),educational background(P = 0.00),R-AFS stage(P = 0.03),dysmenorrhea [9] of patients with endometriosis infertility were analyzed by independent single factor t-test and chi square analysis(P = 0.00),previous pelvic surgery history(P = 0.00),postoperative assisted reproduction(P = 0.00)were the influencing factors of postoperative pregnancy(P < 0.05),while body weight(P =0.32),focus distribution characteristics(ovarian type,peritoneal type,deep infiltration type)(P = 0.07),duration of infertility(P = 0.09),and type of infertility(P= 0.09)were not the influencing factors of postoperative pregnancy rate(P > 0.05).Multiple linear regression analysis showed that age(P = 0.00),duration of infertility(P = 0.00),previous pelvic surgery history(P = 0.00),assisted reproduction(P = 0.00),R-AFS stage(P = 0.03)were independent factors(P < 0.05).ConclusionIn multiple linear regression analysis,age,duration of infertility,previous pelvic surgery history,assisted reproduction,and stage of RAFS were significantly related to the 12-month pregnancy rate of patients with EMS infertility after laparoscopic surgery,which was the influencing factor of the pregnancy rate. |
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