The Effect Of Different Degree Of Control And Treatment Methods On The Outcome Of IVF/ICSI In Patients With Endometriosis Associated With Infertility

Objective To invest whether endometriosis has an effect on the outcome of in vitro fertilization(IVF)and intracytoplasmic sperm injection(ICSI),to explore the different types of the treatment of endometriosis,and focus on the analyze of the impact of satisfaction with treatment of endometriosis on the IVF/ICSI outcomes.Methods A total of 1727 treatment cycles were included in the retrospective study,and according to the degree of satisfaction with treatment of endometriosis were divided into three groups:satisfactory treatment group(group A,575 treatment cycles),unsatisfactory treatment group(group B,483 treatment cycles),untreated group(group C,669 treatment cycles).The retrospective cohort study was conducted to compare the pregnancy outcomes among the groups.The endometriosis patients were divided into simple drug treatment group and surgical excision lesion supplemented by drug treatment group,analysis of whether the IVF/ICSI outcome after two different treatment methods is different.Result(1)Among the satisfactory treatment group(A),unsatisfactory treatment group(B),untreated group(C),high quality embryo rate(55.99%vs 54.47%vs 43.66%,P=0.031),implantation rate(31.93%vs 18.05%vs 11.13%,P<0.01),clinical pregnancy rate per transplant cycle(36.43%vs 14.29%vs 8.33%,P<0.01),abortion rate(22.30%vs 32.61%vs 67.57%,P<0.01),labor rate per transplant cycle(28.31%vs 9.63%vs 2.70%,P<0.01)were statistically differences.Among them,the A group compared with B group,the implantation rate and clinical pregnancy rate were high,the abortion rate was low,the differences were statistically significant(P<0.0167);Group A compared with group C,in addition to the above differences,in the high-quality embryo rate and live birth rate per transplant cycle have significant difference(P<0.0167).Compared with the group C,the group B was slightly better than the group,and there was no significant difference(P>0.0167)except the clinical pregnancy rate and abortion rate(P<0.0167).(2)Compared with simple drug therapy and surgically removing the focal lesions/+ drug therapy of endometriosis,surgically removing the focal lesions/+ drug therapy treated high satisfaction rate,the differences were statistically significant(P=0.010).The labor rate of surgically removing the focal lesions/+ drug therapy is higher,the difference was statistically significant(P<0.05),the other differences were not statistically significant(P>0.05).As for the clinical pregnancy rate,the surgically removing the focal lesions/+ drug therapy group is higher(29.73%vs 14.18%,P=0.078 nearly 0.05).As for the implantation rate,the absolute value of the surgically removing the focal lesions/+drug therapy group was slightly higher(26.79%vs 17.93%),and for the abortion rate(23.37%vs 36.84%)and preterm birth rate(12.77%vs 16.67%),it is lower,but the difference was not statistically significant(P>0.05).Conclusions 1.Endometriosis affects the outcome of IVF/ICSI,needs to be treated,and the degree of disease control and IVF/ICSI outcome is closely related.The satisfaction of disease control can significantly improve the pregnancy outcomes.2.1n ovarian function under the same conditions,surgically removing the focal lesions/+drug therapy of endometriosis treated high satisfaction rate,and endometriosis after resection the lesion by surgical the live birth rate is higher.3.Before IVF/ICSI the treatment of endometriosis best to achieve:Ca125<15IU/ml,VAS score ?4 gynecological examination tenderness.