关键词: Endometriosis Fertility preservation Ovarian stimulation protocols Ovarian surgery

Mesh : Humans Female Endometriosis / therapy surgery Ovulation Induction / methods Infertility, Female / etiology therapy Fertilization in Vitro / methods Gonadotropin-Releasing Hormone

来  源:   DOI:10.1016/j.bpobgyn.2023.102429

Abstract:
Endometriosis is a complex medical condition with a high prevalence in women of reproductive age. Fertility is compromised in patients with endometriosis, and success in IVF treatments has been a challenge leading to evaluation of different stimulation protocols. The long-standing debate between GnRH agonist long protocols and short GnRH antagonist protocols is being resolved in favor of the latter, since in addition to presenting equivalent results with respect to the traditional option, they have the additional benefit of safety. The good results derived from vitrification techniques have led to the development of new stimulation strategies, such as progestin-primed ovarian stimulation (PPOS), with a greater degree of approval among patients. None of the stimulation protocols currently applied in women with endometriosis has been shown to be superior, so early intervention with an Assisted Reproduction treatment, regardless of the chosen protocol, can provide these women with good chances of motherhood. Women with endometrioma should be counseled for fertility preservation before planned ovarian endometrioma excision. The number of cryopreserved oocytes or embryos can be increased by repeated cycles.
摘要:
子宫内膜异位症是一种复杂的医学疾病,在育龄妇女中患病率很高。子宫内膜异位症患者的生育力受损,试管婴儿治疗的成功一直是一个挑战,导致评估不同的刺激方案。GnRH激动剂长方案和短GnRH拮抗剂方案之间的长期争论正在被解决,有利于后者。因为除了提供与传统选项相当的结果之外,他们有安全的额外好处。玻璃化技术的良好结果导致了新的刺激策略的发展,如孕激素促排卵(PPOS),患者的认可程度更高。目前在子宫内膜异位症女性中应用的刺激方案都没有被证明是优越的。所以早期干预辅助生殖治疗,不管选择的协议,可以为这些妇女提供良好的母亲机会。在计划的卵巢子宫内膜瘤切除之前,应建议患有子宫内膜瘤的妇女保留生育能力。冷冻保存的卵母细胞或胚胎的数量可以通过重复循环增加。
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