Objective: To explore the effect of endometriosis (EM) on reproductive outcomes of young patient with EM after laparoscopic treatment in the first in vitro fertilization-embryo transfer (IVF-ET) cycle. Methods: The clinical data and reproductive outcomes of 394 infertile patients with EM after laparoscopic treatment (EM group) and 3 242 infertile patients caused by gamete transport disorder (control group) in the first IVF-ET cycle were collected in Chongqing Health Center for Women and Children from January 2016 to June 2021. The information included baseline characteristics, oocyte retrieval, embryo development, clinical pregnancy, miscarriage, and live birth. Propensity score matching (PSM) method was used to perform 1∶2 matching between EM group and control group. The impact of EM on reproductive outcomes was analyzed in the retrospective observational study. Results: In the initial data, compared with control group, the number of two pronucleus (2PN) zygotes (9.7±4.8 vs 9.0±4.4), the number of transferable embryos (6.2±3.6 vs 5.5±3.4) and the rate of transferable embryos (64.0% vs 60.8%) on the third day were significantly lower in EM group, and the differences were statistically significant (all P<0.05). After PSM was performed, there were 394 and 787 cases in EM group and control group, respectively. Compared with control group, the number of 2PN zygotes (9.7±4.9 vs 9.0±4.4), the 2PN fertility rate (77.1% vs 75.3%), the number of transferable embryos on the third day (6.2±3.6 vs 5.5±3.4), the transferable embryos rate on the third day (63.8% vs 60.8%) were significantly lower in EM group, and the differences were statically significant (all P<0.05). The study did not find the effect of EM on embryo implantation rate, pregnancy rate, early miscarriage rate, live birth rate and preterm birth rate (all P>0.05). Conclusions: EM might interfere with the development of oocytes and embryos. Obtaining top-quality embryos may be an effective way to improve the prognosis of patients with EM after laparoscopic treatment.
目的： 分析子宫内膜异位症（内异症）对腹腔镜手术后首次行体外受精-胚胎移植（IVF-ET）年轻患者临床结局的影响。 方法： 通过回顾性观察研究，收集重庆市妇幼保健院2016年1月至2021年6月首次行IVF-ET治疗的内异症腹腔镜术后患者（394例，内异症组）和单纯盆腔输卵管因素导致的不孕症患者（3 242例，对照组）的临床资料，包括基线资料、获卵情况、胚胎发育情况、临床妊娠、早期流产和活产情况；采用1∶2倾向性评分匹配（PSM）对两组患者进行匹配，分析内异症对临床结局的影响。 结果： PSM匹配前，与对照组相比，内异症组患者的双原核（2PN）受精卵数［分别为（9.7±4.8）、（9.0±4.4）个］、第3天可用胚胎数［分别为（6.2±3.6）、（5.5±3.4）个］和第3天可用胚胎率（分别为64.0%、60.8%）均明显降低，分别比较，差异均有统计学意义（P均<0.05）。PSM匹配后，内异症组有394例，对照组有787例；与对照组相比，内异症组的2PN受精卵数［分别为（9.7±4.9）、（9.0±4.4）个］、2PN受精率（分别为77.1%、75.3%）、第3天可用胚胎数［分别为（6.2±3.6）、（5.5±3.4）个］和第3天可用胚胎率（分别为63.8%、60.8%）均明显降低，分别比较，差异均有统计学意义（P均<0.05）。PSM匹配前、匹配后，两组患者之间胚胎着床率（内异症组为49.7%）、临床妊娠率（内异症组为65.3%）、异位妊娠率（内异症组为2.3%）、早期流产率（内异症组为6.1%）、活产率（内异症组为58.2%）和早产率（内异症组为13.3%）均无明显差异（P均>0.05）。 结论： 内异症可能影响腹腔镜手术治疗后的年轻内异症患者首次IVF-ET时卵母细胞和胚胎的发育，获得高质量胚胎可能是改善卵巢储备功能正常患者生殖预后的有效途径。.