Research question

What prognostic factors relate to a high oocyte yield in fertility preservation for women affected by endometriosis?

Design

Observational cohort study conducted in a tertiary care university hospital between April 2015 and January 2019. Women who had undergone fertility preservation with ovarian stimulation for oocytes and embryo vitrification for endometriosis were included. Prognostic factors associated with the number of oocytes retrieved after the first ovarian stimulation were analysed.

Results

A total of 146 women who had undergone 258 ovarian stimulation cycles were included; 82 (56.2%) had undergone more than one ovarian stimulation cycle; 72.6% had at least one endometrioma lesion; and 36.3% had previously undergone surgery for endometriosis. After adjustment by multiple linear regression, the factors that significantly reduced the number of oocytes retrieved were previous history of surgery for ovarian endometriosis (coefficient –1.08; 95% CI –2.02 to –0.15; P = 0.024); women's age (–0.21; 95% CI –0.41 to –0.01; P = 0.039); and total dose of gonadotrophin used (–0.01; 95% CI –0.01 to –0.00; P = 0.047). Anti-Müllerian hormone serum level and gravidity positively correlated with an increase in the number of oocytes retrieved (1.65; 95% CI 1.13 to 2.17; P < 0.001 and 3.30; 95% CI 0.91 to 5.68; P = 0.007, respectively) after the first ovarian stimulation cycle.

Conclusion

A history of surgery for ovarian endometriosis was associated with significantly lower oocyte yields. Fertility preservation should be integrated into endometriosis management. Fertility preservation should ideally be made available to the patient before surgery.

中文翻译：

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子宫内膜异位症患者的生育力保存最好在手术前进行

研究问题

哪些预后因素与受子宫内膜异位症影响的女性在保留生育能力方面的高卵母细胞产量相关？

设计

2015 年 4 月至 2019 年 1 月在一家三级护理大学医院进行的观察性队列研究。纳入了通过卵巢刺激卵母细胞和胚胎玻璃化治疗子宫内膜异位症进行生育力保存的女性。分析了与第一次卵巢刺激后获得的卵母细胞数量相关的预后因素。

结果

共有 146 名女性接受了 258 个卵巢刺激周期；82 人 (56.2%) 经历了一个以上的卵巢刺激周期；72.6% 有至少一处子宫内膜异位病变；36.3% 曾接受过子宫内膜异位症手术。经多元线性回归调整后，显着减少取卵数量的因素是既往卵巢子宫内膜异位症手术史（系数–1.08；95% CI –2.02至–0.15；P  = 0.024）；女性年龄（–0.21；95% CI –0.41 至 –0.01；P  = 0.039）；和使用的促性腺激素总剂量（–0.01；95% CI –0.01 至 –0.00；P = 0.047)。抗苗勒管激素血清水平和妊娠率与取卵数增加呈正相关（1.65；95% CI 1.13 至 2.17；P < 0.001 和 3.30；95% CI 0.91 至 5.68；P  = 0.007）第一个卵巢刺激周期。

结论

卵巢子宫内膜异位症手术史与卵母细胞产量显着降低有关。生育力保存应纳入子宫内膜异位症的管理。理想情况下，应在手术前为患者提供生育力保存。