No difference in cycle pregnancy rate and in cumulative live-birth rate between women with surgically treated minimal to mild endometriosis and women with unexplained infertility after controlled ovarian hyperstimulation and intrauterine insemination

被引:89
作者
Werbrouck, Erika [1 ]
Spiessens, Carl [1 ]
Meuleman, Christel [1 ]
D'Hooghe, Thomas [1 ]
机构
[1] Katholieke Univ Leuven Hosp, Leuven Univ Fertil Ctr, Louvain, Belgium
关键词
intrauterine insemination; controlled ovarian hyperstimulation; minimal to mild endometriosis; unexplained infertility;
D O I
10.1016/j.fertnstert.2006.01.044
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: The association between infertility and minimal to mild endometriosis is controversial and poorly understood. The clinical pregnacy rate (PR) per cycle after controlled ovarian hyperstimulation (COH) with or without intrauterine insemination (IUI) is reportedly lower in women with surgically untrated minmal to mild endometriosis than in women with unexplained infertility. it is possible that prior laparoscopic removal of endometriosis has a positive effect on the clinical PR after COH and IUI. Therefore, we tested the hypothesis that after COH and IUI the Pr per cycle and the cumulative live-birth rate (CLBR) are epual or higher i women with recently surgically treated minimal to mild endometriosis when compared with women with unexplained infertility. Design: A retrospective, controlled cohort study. Setting: Leuven University Fertility Centre, a tertiary academic referral center. Patient(s): One hundred seven women treated during 259 cycles with COH and IUI including patients with endometriosis (n = 58, 137 cycles) and unexplained infertility (n = 49, 122 cycles). All patients with endometriosis had minimal (n = 41, 100 cycles) or mild (n = 17, 37cycles) disease that had been laparoscopically removed within 7 months before the onset of treatment with COH and IUI. Intervention(s): Controlled ovarian hyperstimulation using clomiphene citrate (23 cycles) or gonadotrophins (236 cycles) in combination with IUI. Main Outcome Measure(s): Clinical PR per cycle and CLBRwithin four cycles of treatment with COH and IUI. Result(s): The clinical PR per cycle was comparable in women with minimal or mild endometriosis (21% or 18.9%, respectively) and in women with unexplained infertility (20.5%). The CLBR within four cycles of COH and IUI was also comparable in women with minimal endometriosis, mild endometriosis and unexplained infertility mini endo infertility (70.2%, 68.2%, 66.5%, respectively). Conclusion(s): The data from our study suggest that COH and IUI shortly after laparoscopic excision of endometriosis is as effective-as COH and IUI in patients with unexplained subfertility.
引用
收藏
页码:566 / 571
页数:6
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