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目的探讨不孕症妇女卵巢良性囊肿及手术剔除后卵巢功能评价指标的变化。方法选择2013年7月至2014年2月中山大学孙逸仙纪念医院生殖中心第1周期体外授精(in vitro fertilization,IVF)/卵胞浆内单精子注射(intracytoplasmic sperm injection,ICSI)助孕的不孕症伴发卵巢良性囊肿及手术剔除的患者50例作为研究组,同期因输卵管性或男方因素不孕妇女50例作为对照组,比较两组患者的卵巢功能评价指标和助孕结局。结果未行手术治疗囊肿者卵巢体积[(18.64±14.67)m L]较对照组[(6.19±3.58)m L]明显增大(P<0.05),临床妊娠率(87.50%)高于对照组(45.65%)(P<0.05)。卵巢囊肿手术剔除者抗苗勒氏管激素水平[(2.35±2.02)ng/m L]和窦卵泡个数[(10.67±6.04)个]低于对照组[(3.84±2.84)ng/m L、(13.88±7.32)个](P<0.05)。无论是否采用手术治疗卵巢囊肿,控制性卵巢刺激时研究组促性腺激素总用量均显著高于对照组(P<0.05)。卵巢囊肿手术剔除者获卵数[(9.50±6.68)个]少于对照组[(12.54±5.50)个](P<0.05);单侧卵巢囊肿剔除者手术侧卵巢获卵数[(4.22±3.63)个]少于健侧卵巢[(6.00±4.49)个](P<0.05)。结论直径<5 cm的卵巢良性囊肿存在没有对不孕妇女卵巢储备功能造成影响,手术剔除后卵巢储备功能呈现下降的趋势,但无论是否采取手术治疗,患者的生殖潜能都未受到明显损害。
Objective To investigate the changes of benign ovarian cysts in women with infertility and ovarian function after culling. Methods The infertile women who underwent in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) fertilization during the first cycle of reproductive center of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from July 2013 to February 2014 were enrolled. 50 cases of patients with benign ovarian cysts and surgical rejection were selected as the study group. 50 cases of infertile women with tubal or male factor were selected as the control group during the same period, and the ovarian function evaluation index and assisted pregnancy outcome were compared between the two groups. Results The volume of ovary without surgical treatment of cyst was significantly higher than that of the control group [(18.64 ± 14.67) m L] (6.19 ± 3.58 m L] (P <0.05), and the clinical pregnancy rate (87.50%) was higher than that of the control group (45.65%) (P <0.05). The level of anti-Müllerian hormone ([(2.35 ± 2.02) ng / m L] and the number of antral follicles in ovariectomy patients [(10.67 ± 6.04)] were lower than that of the control group [(3.84 ± 2.84) ng / m L , (13.88 ± 7.32)] (P <0.05). Regardless of surgical treatment of ovarian cysts, the total amount of gonadotropin in the study group was significantly higher than that of the control group (P <0.05). Ovarian cyst surgeries had fewer oocytes [(9.50 ± 6.68)] than those in the control group [(12.54 ± 5.50)] (P <0.05) 3.63)] less than the contralateral ovary [(6.00 ± 4.49)] (P <0.05). Conclusions The presence of benign ovarian cysts <5 cm in diameter does not affect the ovarian reserve in infertile women. However, the reserve of ovarian reservoirs tends to decline after the operation is removed. However, the reproductive potential of the patients has not been significantly impaired with or without surgical treatment.