ISSN: 2148-8274 / E-ISSN: 2587-0084
, Türk Üreme Tıbbı ve Cerrahisi
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Turkish Journal of Reproductive Medicine and Surgery

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İn Vitro Fertilizasyon Yapılan Endometriozisli Olgularda Opere Olan ve Olmayan Hastaların Sonuçlarının Karşılaştırılması
Characteristics of Infertility Cases with Endometriosis Treated by In Vitro Fertilization Who Had Previously Endometriosis Surgery or Not
Received Date : 27 Feb 2020
Accepted Date : 01 Mar 2020
Available Online : 08 Jun 2020
Doi: 10.24074/tjrms.2020-74570 - Makale Dili: TR
TJRMS. 2019;3(1):15-21
ÖZET
Amaç: Endometriozisli olgularda IVF başarısını olumsuz yönde etkilemeden, operasyondan fayda görecek hasta grubunu belirlemektir. Gereç ve Yöntemler: Çalışma 2000-2017 yılları arasında IVF yapılan, endometriozis tanısı olan 144 hasta ve bu 144 hastaya uygulanan 210 adet IVF siklusu içeren retrospektif bir çalışmadır. Çalışmada hastalar endometriozis nedeniyle operasyon geçirmemiş ve operasyon geçirmiş olarak iki gruba ayrılmıştır. Opere olan grup endometrioma, derin infiltratif endometriozis nedeniyle laparoskopi yapılmış hastaları içermektedir. IVF tedavisi esnasında ihtiyaç duyulan gonadotropin dozu ve süresi, ovulasyon indüksiyonu süresince değerlendirilen E2, LH, progesteron seviyelerindeki farklılıklar, transfer edilen embriyoların sayı ve kaliteleri, klinik ve canlı gebelik sonuçları üzerinden karşılaştırılmıştır. Bulgular: Çalışmaya göre gebe kalabilen grup daha genç saptanmış, 35 yaş altında opere olmuş grupta gebelik oranlarının 35 yaş üstüne göre daha iyi olduğu görülmüştür. Transfer edilen ilk embriyo grade 1 olduğunda opere grubun gebelik hızı belirgin olarak fazla saptanmıştır. İkinci embriyo da grade 1 verildiğinde opere olmayan grupta mevcut olan 8 hastada gebelik izlenmezken, opere grupta %57,4 oranında gebelik saptanmış ve istatistiksel olarak gebelik hızı opere olan grupta fazla görülmüştür. Sonuç: Sonuç olarak cerrahinin over rezervini azaltabilmesine karşılık bizim çalışmamızda opere olan hasta grubunda 35 yaşın altında olmak cerrahinin etkisini ortadan kaldırmaktadır.
ABSTRACT
Objective: Our purpose is to determine the patients who will benefit from the operation without affecting the success of IVF in patients with endometriosis. Material and Methods: In our study, we compared 144 infertility patients with 210 IVF cycles between the ages 18-45, referred Gazi University Center for Assisted-Reproduction between 2000 and 2017 for treatment. Patients with endometriosis distributed into two groups; operated or non-operated. Variables such age, infertility duration, ovulation induction protocols, gonadotropin cumulative doses, duration of induction, E2, LH, and progesterone levels, quality of embryos, clinical and take home baby rates were evaluated. Results: According to the results of the study, the pregnant group was found to be younger, in operated group pregnancy rates under 35 years of age were better than over 35 years. When the first embryo transferred was grade 1, the rate of pregnancy of the operated group was significantly higher. While the second embryo was given grade 1, in 8 patients who were in the non-operated group, the pregnancy was not observed, in the operated group, 57.4% of the patients were found to be pregnant so the rate of pregnancy was statistically higher in the operated group. Conclusion: In conclusion, despite the fact that surgery can reduce ovarian reserve, in our operated patient group, being under 35 years of age eliminates probable negative effect of surgery on folliculles.
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