作　　者： (李世杰）; (孙广范）; (林霞）; (林秀峰）; (吴日然）; (柯玩娜）;

机构地区： 中山市博爱医院生殖内分泌科,广东中山528400

出　　处： 《中国计划生育和妇产科》 2017年第9期28-31,共4页

摘　　要： 目的通过对子宫内膜异位症(endometriosis,EMs)生育指数(endometriosis fertility index,EFI)的研究,探讨其对EMs合并不孕患者生育力评估的临床价值。方法前瞻性分析中山市博爱医院生殖内分泌科2014年1月至2015年11月因不孕就诊,行腹腔镜检查证实为EMs患者190例,术中进行EFI评分;术后随访12个月,随访术后疗效及妊娠情况。结果术后12个月累积妊娠率48.42%(92/190)。期待自然妊娠患者的累积妊娠率,在EFI评分8~10分组为46.51%(20/43),高于5~7分组(15.38%,2/13),差异有统计学意义(χ~2=5.2,P<0.05)。促排卵-人工授精(controlled ovarian hyperstimulation-intrauterine insemination,COH-IUI)患者的累积妊娠率,EFI评分8~10分组为59.45%(22/37),高于5~7分组(33.33%,8/24),差异有统计学意义(χ~2=3.98,P<0.05)。体外受精-胚胎移植(in vitro fertilizationembryo transfer,IVF-ET)患者的累积妊娠率,在EFI评分8~10分组为69.69%(23/33),高于5~7分组(50%,15/30)及1~4分组(20%,2/10),差异有统计学意义(χ~2=8.12,P<0.05)。EFI与术后1年累积妊娠率有关(P<0.05)。在EFI评分8~10分组及5~7分组,IVF-ET患者的累积妊娠率均较期待自然妊娠患者增高,差异有统计学意义(χ~2=4.09、4.55,P<0.05);COH-IUI患者的累积妊娠率与自然妊娠患者比较差异均无统计学意义(χ~2=1.34、1.38,P>0.05)。结论 EMs患者EFI与术后妊娠率呈正相关,能够评价EMs合并不孕患者的生育能力;腹腔镜术后辅助IVF-ET术可以提高患者的妊娠率。因此EFI评分对指导有生育要求的EMs患者进行生育方式的选择有一定的意义。 Objective To study the clinical value of endometriosis fertility index（EFI） on fertility of patients with endometriosis （EMs） combined with infertility. Methods A prospective analysis was performed in 190 infertile patients with EMs who underwent laparoscopic surgery in the Department of Reproductive Endocrinology ofZhongshan Boai Hospital from January 2014 to November 2015. EFI was scored during operation and pregnancy outcome was investigated after 12 months of follow up. Results At 12 months after operation, the cumulative pregnancy rate was 48.42 % in all patients （92/190）. In patients who expected natural pregnancy, the pregnancy rates of EFI score 8 to 10 points was 46. 51% （20/43）, 5 to 7 points was 15.38 % （2/13） ,the difference was statistically significant （X2 = 5.2, P 〈0. 05 ）. In patients who underwent controlled ovarian hyperstimulation - intrauterine insemination （ COH - IUI）, the pregnancy rates of EFI score 8 to 10 points was 59. 45 % （22/37）, 5 to 7 points was 33.33 % （8/24）. The difference was statistically significant（x2 = 3.98, P 〈 0. 05 ） . In patients who underwent in vitro fertilization - embryo transfer （ IVF - ET）, the pregnancy rates of EFI score 8 to 10 points was 69. 69 % （23/33） , 5 to 7 points was 50 % （15/30）, ≤4 points was 20 % （2/10）. The difference was statistically significant （X2 = 8.12 ,P 〈 0. 05 ）. EFI and the cumulative pregnancy rates of 1 year had a correlation（ P 〈 0. 05 ）. In IVF -ET Patients, the pregnancy rates of EFI score 8 to 10 point, 5 to 7 points were higher than in expected natural pregnancy,and the difference was statistically significant （X2 = 4. 09, 4. 55, P 〈 0. 05 ）. There were no difference in cumulative pregnancy rates between patients who underwent COH - IUI and expected natura/ pregnancy （x2 = 1.34, 1.38 ,P 〉0. 05）. Conclusion EFI and postoperative pregnancy outcome has a positive correlation, EFI score could effectively evaluate the fertility of patients with EMs com

关 键 词： 子宫内膜异位症 不孕 生育指数 妊娠率