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대한생식의학회지 제31권 제2호 2010년
난소의 자궁내막종에 대한 다양한 치료적 적용에 따른 체외수정 및 배아이식술 결과의 비교 연구
매이저 병원 산부인과, 불임연구소
이방현, 권혁찬, 이재현, 김보현, 이상희, 박민혜, 이병관, 임정애
Comparison of IVF-ET Outcome after Various Therapeutic Approaches for Ovarian Endometriomas
Bang Hyun Lee, Hyuck Chan Kwon, Jae Hyun Lee, Bo Hyun Kim, Sang Hee Lee, Min Hye Park, Byung Kwan Lee, Jung Ae Lim
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, Major Womens Care Center, Seoul, Korea
Objective: To compare COH characteristics and IVF outcomes among IVF-ET patients who were treated with various therapeutic modalities for ovarian endometriomas and to propose effective pre-cyclic therapeutic modalities to improve IVF-ET outcomes in the patients with ovarian endometriomas. Methods: All cases that had undergone IVF-ET after laparoscopy between January 1997 to August 2003 were reviewed. Forty-eight patients with tubal factor were assigned to Group I. Twenty seven, 22 and 38 patients diagnosed as severe pelvic adhesion with ovarian endometriomas by laparoscopy received only medical therapy (Group II), cyst aspiration (Group III), and sclerotherapy (Group IV), respectively. Laparoscopic cystectomy was performed in 20 patients (Group V). Resistance index was measured on day administering hCG. Results: As compared with Group I, in Group II resistance index increased (p<0.05) but number of oocytes, good-quality oocyte ratio (mature and intermediate oocytes/total retrieval oocytes), fertilization rate, and embryo development rate decreased (p<0.05). In Group III fertilization rate and embryo development rate decreased (p<0.05). There was no difference between Group IV and Group I in all parameters except basal FSH which increased (p<0.05). In Group V basal FSH, and resistance increased (p<0.05) and number of oocytes and good-quality oocytes ratio decreased (p<0.05). Conclusion: Sclerotherapy is an effective therapeutic option which can be done prior to IVF-ET cycles in the patients with ovarian endometriomas. Further studies on a large scale are necessary to confirm these data.
키워드 : Ovarian endometriomas, Sclerotherapy, Cystectomy, IVF-ET
교신저자 : gillhyum@hanmail.net
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