子宮內膜異位瘤對於IVF懷孕母親，胎兒及新生兒並無不良影響

子宮內膜異位瘤病患施行IVF懷孕後，

對於懷孕母親，胎兒及新生兒並無不良影響

http://humrep.oxfordjournals.org/content/27/6/1663.full

Pregnancy outcome in women with endometriomas achieving pregnancy through IVF

1. Laura Benaglia1,*, 
2. Alfonso Bermejo2, 
3. Edgardo Somigliana1,
4. Claudia Scarduelli1, 
5. Guido Ragni1, 
6. Luigi Fedele1 and
7. Juan A. Garcia-Velasco2

+Author Affiliations

1. ¹Infertility Unit, Department of Obstetrics and Gynecology, Fondazione Cà Granda, Ospedale Maggiore Policlinico, Via M. Fanti, 6-20122 Milan, Italy
2. ²IVI Madrid, Rey Juan Carlos University, Madrid, Spain

1. ↵*Correspondence address. Tel: +39-0255034303; Fax: +39-0255034302; E-mail: laurabenaglia@hotmail.it

• Received June 9, 2011.
• Revision received January 23, 2012.
• Accepted January 27, 2012.

 

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Abstract

BACKGROUND There is a growing consensus that ovarian endometriomas should not be systematically removed in women selected for IVF. However, some recent evidence suggested that the presence of these cysts may negatively affect the course of pregnancy.

METHODS We set up a multicenter retrospective cohort study, including two infertility units. We analyzed data from patients achieving singleton clinical pregnancies through IVF comparing the pregnancy outcome between 78 pregnant women with endometriomas at the time of IVF and 156 patients who achieved pregnancy through IVF without endometriomas.

RESULTS The number of live births in women with and without endometriomas were 61 (78%) and 130 (83%), respectively (P = 0.39). The adjusted odds ratio (OR) of live birth in affected cases was 0.79 [95% confidence interval (CI): 0.38–1.68]. No differences were observed in late pregnancy and neonatal outcomes between the two groups. In particular, the rate of preterm birth and small-for-gestational age (SGA) was similar. The adjusted ORs were 0.47 (95% CI: 0.14–1.54) and 0.56 (95% CI: 0.12–2.56), respectively.

CONCLUSIONS Women with endometriomas achieving pregnancy through IVF do not seem to be exposed to a significant increased risk of obstetrical complications.

Pregnancy outcome in women with endometriomas achieving pregnancy through IVF

Table III

Pregnancy and neonatal complications in women with and without endometriomas.

Characteristics	Endometriomas (n= 61)	No endometriomas (n= 130)	P-value	Adj. OR (95%CI)
Prematurity (<37 weeks of gestation)	4 (7%)	18 (14%)	0.22	0.47 (0.14–1.54)
SGA birth (<10th centile)	3 (5%)	8 (6%)	1.00	0.56 (0.12–2.56)
Fetal weight <2500 g	5 (8%)	17 (13%)	0.47	0.61 (0.20–1.86)
Severe obstetrical complicationsa	7 (12%)	10 (8%)	0.42	1.86 (0.61–5.68)
Cesarean section	23 (38%)	44 (34%)	0.63	1.25 (0.63–2.50)
Neonatal complicationsb	5 (8%)	15 (11%)	0.61	0.62 (0.19–1.94)

• P-values refer to univariate analysis. Adjusted (Adj.) OR was calculated using a logistic regression model (see text).
• ^aThey include pre-eclampsia (three cases and two unexposed women), placenta previa (three cases and one unexposed woman) and abruptio placenta (three unexposed women), growth restriction (three cases) and macrosomy (one case and one unexposed woman).
• ^bThey included monolateral hydronephrosis (1 case), perinatal asphyxia (10 cases and 4 unexposed women), necrotizing enterocolitis (1 unexposed woman), congenital dislocation of the hip (1 unexposed woman), hypospadia (one unexposed woman) and intravenous cerebral malformation (1 unexposed woman).