摘要
Abstract
Hormonal treatment does not improve the fecundity of infertile women with endometriosis. In stage I/O endometriosis,laparoscopic ablation of endometrial implants has been associated with a significant improvement in live birth rates. While in women with stage III -IV endometriosis conservative surgical treatment with laparoscopy and possible laparotomy plus GnRH agonist may increase fertility, but there is some objection. There is no evidence that the outcome is affected by the method of ablation,either electrosurgery or laser delivery systems in laparoscopy. Patients with endometriosis-associated infertility undergoing assisted reproduction respond with significantly decreased 37% pregnancy rate comparing that of women with tubal factor infertility for IVF. Prolonged use of GnRH agonist before IVF-ET in patients with endometriosis resulted in significantly higher ongoing pregnancy and implantation rates than standard controlled ovarian hyperstimulation regimens. There are some evidence supporting the idea that surgery may negatively affect ovarian reserve and other investigator consider that negatively affect will decrease to minimal by practices accumulating and protecting ovarian tissue. Patients in stage I - II endometriosis with infertility should be expect to nature fecundity months after laparoscopy, and who in stage III - IV will be suggested to get assisted reproduction. There are heated argument in laparoscopy before IVF-ET/ICSI. When recurrent of endometriosis are present, more than one time IVF after GnRH agonist treatment of severe month have better pregnancy rates than laparoscopy again. Treatment with a GnRH agonist for 3-6 months before IVF in women with endometriosis increases the rate of clinical pregnancy as negative effect of fertility in many mechanisms by endometriosis. There are some introduction in Endometriosis Fertility Index (EFI) ,some guideline and committee opinion from European Society of Human Reproductive and Embryology (ESHRE), American Society of Reproductive Medicine (ASRM) and Chinese Medicine Association. The treatment strategy in endometriosis and infertility of author's ART center is introduction.关键词
子宫内膜异位症/不育,女(雌)性/治疗/受精,体外Key words
Endometriosis/Infertility, female/Therapy/Fertilization in vitro
