| Objective Endometriosis is a common disease among infertile women.However, the mechanism of endometrisis-associated infertility remains unknown after many years investigation.Recently,In vitro fertilization-embryo transfer(IVF-ET) has become a common method to help infertile women with endometriosis to get pregnant. Meanwhile,the IVF-ET outcomes of these women are greatly controversial among different studies.In present study,we conducted a retrospective investigation,aiming to assess the ovary reserve of infertile patients with endometriomas and the impact of endometriomas on IVF-ET procedure.Furthermore,we also analyzed the data from women with cystectomy so as to investigate the impact of cystectomy on ovary reserve.Method 108 infertile patients with endometrioma(A group) and 113 tubual infertile patients(B group)attending to the clinic of Shandong Provincial Hospital Human Reproductive Center between June 2007 and September 2008 were included in this retrospective study.All of them were performed IVF-ET or ICSI-ET procedure. Recorded and compared basal FSH level,number of basal antrual follicles,level of estradiol on HCG injection day,number of oocytes retrieved,fertilization rate,and pregnancy rates and other parameters between the two groups.Result Age of patients between endometrioma group and tubal factor group were similar(31.61±3.10,32.35±4.33).Compared with tubal factor group, endometrioma group showed significantly higher basal FSH level(9.86±4.38IU/L, 8.02±1.89IU/L),p＜0.05;higher amount of Gn used(3660.12±1631.76IU, 2157.80±857.68IU),p＜0.05;lower level of estradiol on HCG injection day (2426.48±1521.42 pg/ml,3217.09±2343.99 pg/ml),p＜0.05;fewer mature follicles(6.32±3.52,8.50±3.69),p＜0.05.Fewer oocytes were retrieved from group A than from group B(9.43±6.34,13.57±8.23),p＜0.05;Group A had significantly thicker endometrium on HCG injection day(1.16±0.20 cm,1.07±1.18 cm),p＜0.05;without type difference.Fertilization rate,good-embryo rate and pregnance rate were similar among the two groups.When Comparation was made between patients with previous cystectomy and those who had no ovary surgery history,both groups had similar basal FSH level(9.97±4.4 5IU/L,9.58±4.26 IU/L),p＞0.05;similar antrual follicles(9.42±4.01,9.22±3.48),p＞0.05.But the former group had significantly fewer mature follicles on HCG injection day(5.70±3.22,7.81±3.79),p＜0.05;lower level of estradiol on HCG injection day(2234.90±1331.42 pg/ml,2894.78±1846.71 pg/ml),p＜0.05; fewer oocytes retrieved(8.38±5.62,12.00±7.30),p＜0.05.Conclusion Patients with endometrioma have diminished ovary reserve and poorer ovary's response to gonadotropin than tubal factor infertile women with similar age, and cystectomy may even aggravate this damages.However,endometrioma seemed not affect the outcome of IVF-ET. |
