CAJ | 학술논문

目的探讨中重度子宫内膜异位症患者使用促性腺激素释放激素激动剂(GnRH-a)治疗后妊娠情况.方法选取中重度子宫内膜异位症患者61例,其中期待组(48例)予期待妊娠,必要时监测排卵或常规促排卵,辅助生殖组(13例)予体外受精-胚胎移植,观察比较两组患者术后使用GnRH-a治疗后的妊娠情况.结果61例患者总妊娠率67.2%(41/61).期待组月经恢复的0~3个月妊娠率(56.3%,27/48)明显高于月经恢复第4~12个月的妊娠率(12.5%,6/48),差异有统计学意义(P<0.05).辅助生殖组月经恢复的0~3个月妊娠率(30.8%,4/13)与月经恢复第4~12个月的妊娠率(30.8%,4/13)差异无统计学意义(P>0.05).月经恢复后的1年内,两组患者妊娠率的差异无统计学意义(P>0.05).GnRH-a使用3次与使用4~6次比较,妊娠率的差异无统计学意义(P>0.05).结论中重度子宫内膜异位症性患者,使用3次GnRH-a治疗,在月经恢复前及恢复最初3个月积极指导患者期待妊娠,在月经恢复3个月后及合并子宫内膜异位症外其他不孕因素的患者尽早给予辅助生殖治疗,有利于提高妊娠率.
목적탐토중중도자궁내막이위증환자사용촉성선격소석방격소격동제(GnRH-a)치료후임신정황.방법선취중중도자궁내막이위증환자61례,기중기대조(48례)여기대임신,필요시감측배란혹상규촉배란,보조생식조(13례)여체외수정-배태이식,관찰비교량조환자술후사용GnRH-a치료후적임신정황.결과61례환자총임신솔67.2%(41/61).기대조월경회복적0~3개월임신솔(56.3%,27/48)명현고우월경회복제4~12개월적임신솔(12.5%,6/48),차이유통계학의의(P<0.05).보조생식조월경회복적0~3개월임신솔(30.8%,4/13)여월경회복제4~12개월적임신솔(30.8%,4/13)차이무통계학의의(P>0.05).월경회복후적1년내,량조환자임신솔적차이무통계학의의(P>0.05).GnRH-a사용3차여사용4~6차비교,임신솔적차이무통계학의의(P>0.05).결론중중도자궁내막이위증성환자,사용3차GnRH-a치료,재월경회복전급회복최초3개월적겁지도환자기대임신,재월경회복3개월후급합병자궁내막이위증외기타불잉인소적환자진조급여보조생식치료,유리우제고임신솔.
Objective To investigate the pregnant outcomes of patients with moderate or severe endometriosis treated with gonadotropin-releasing hormone agonist (GnRH-a). Methods Sixty one cases with moderate or severe endometriosis were treated with GnRH-a from December 2009 to February 2012, including 48 cases who were monitored with ultrasound B or received ovulation stimulating for anovulatory women (expectant group), and 13 cases who underwent in vitro fertilization and embryo transfer (ART group). The pregnant outcomes of two groups were prospectively analyzed. Results The overal pregnant rate was 67.2%. The pregnant rate during the first 3 months of the menstruation return was significantly higher than that during the 4~12th months of menstruation return in expectant group (56.3%、12.5%, P<0.05), but there was no significant difference in ART group between two groups (30.8%、30.8%, P>0.05). There was no significant difference in the pregnant rate between two groups in the 1 year of the of menstruation return (P>0.05), and no differences between patients received 3 and 4~6 times injection of GnRH-a(P>0.05). Conclusion The results suggest that three injections of GnRH-a and guide for natural conception before and during the first 3 months of menstruation return or adopting assisted reproductive technology soon after 3 months of menstruation return may improve the pregnant rate of patients with moderate or severe endometriosis.