Résumé
Background: Endometriosis can be defined as presence of endometrial mucosa outside the uterine cavity. There are no specific signs and symptoms of endometriosis and the presentation may vary depending upon the site of involvement. It is one of the common causes of subfertility and infertility in young women. The Management of endometriosis may include medical as well as surgical intervention. Laparoscopic interventions have found to have encouraging results in terms of increasing chances of fertility in young women with endometriosis.Methods: This was a prospective study in which women who had infertility and subsequently diagnosed to be having endometriosis were included. A detailed history was taken with particular emphasis on duration of symptoms, presence of additional co-morbidities and duration of infertility was recorded. Diagnostic laparoscopy was done in all the cases. Depending upon location and severity of endometriosis adhesiolysis, excision and ablation of endometrial lesions was done. Patients were followed up and successful pregnancies (spontaneous as well as secondary to assisted reproductive techniques) were recorded.Results: Out of 200 studied cases endometriosis was seen in 23 (11.5%) patients. the most common affected age group was between 26-30 years (47.83%). 18 patients (78.26%) had primary infertility whereas remaining 5 patients (21.74%) were found to have secondary infertility. The most common site was found to be ovaries which was found to be involved in all the cases. cystectomy (30.43%), endometrioma drainage and fulguration (13.04%) or adhesiolysis (34.78%) were the commonly done surgical interventions in cases. out of 18 patients who had successful ovulation following laparoscopic intervention 12 (66.66%) patients completed their pregnancies successfully.Conclusions: Laparoscopic interventions in patients with infertility have diagnostic as well as therapeutic value and are found to have good outcome in terms of successful pregnancy.
Résumé
OBJECTIVE@#To observe the effects of acupoint catgut embedding on miscarriage prevention and pregnancy outcome in patients with threatened abortion after in vitro fertilization-embryo transfer (IVF-ET).@*METHODS@#Sixty cases of patients with threatened abortion after IVF-ET were randomly divided into an observation group and a control group, 30 cases in each group. The patients in the control group were treated with intramuscular injection of progesterone (40 mg) once every day, while the patients in the observation group, on the basis of the treatment of control group, were treated with catgut embedding at Geshu (BL 17), Ganshu (BL 18), Shenshu (BL 23), Pishu (BL 20), Weishu (BL 21), Xuehai (SP 10), Diji (SP 8) and Fuliu (KI 7), once every two weeks, six times as a course of treatment. The treatment was given until 12 weeks into pregnancy. The level of serum human chorionic gonadotropin (HCG), estradiol (E) and progesterone (P) before and after treatment was recorded; the TCM syndrome score before and after treatment was compared; the successful pregnancy rate and spontaneous abortion rate after treatment were observed in the two groups.@*RESULTS@#Compared before treatment, the scores of TCM syndrome in both groups were reduced after treatment (both <0.01), and score in the observation group was superior to that in the control group (<0.05). After treatment, the clinical efficacy in the observation group was superior to that in the control group (<0.05). After treatment, the hormone levels (β-HCG, E, P) in both groups were increased steadily; the hormone levels in 6-week pregnancy, 8-week pregnancy and 10-week pregnancy were significantly higher than those in 4-week pregnancy (all <0.05); except the levels of P and β-HCG in 10-week pregnancy, the hormone levels in the observation group were superior to those in the control group (all <0.05). After treatment, the early abortion rate was 16.7% (5/30) in the observation group, which was lower than 33.3% (10/30) in the control group (<0.01); the pregnancy rate was 96.0% (24/25) in the observation group, which was higher than 80.0% (16/20) in the control group (<0.01).@*CONCLUSION@#Acupoint catgut embedding is effective for preventing threatened abortion, which could significantly reduce the spontaneous abortion rate, improve the pregnancy success rate, regulate hormone levels in patients after IVF-ET.