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Objective

目的

To evaluate combined effects of age and endometriosis on ovarian reserve in women with infertility.

评估子宫内膜异位症和年龄因素对不孕女性卵巢储备的影响。

Materials and Methods

材料和方法

This was a cross-pal study using an institutional database. Women with sonographic, laparoscopic, or histological evidence of endometriosis were defined as the study group whereas the remainders served as the control group. First, we evaluated demography and clinical characteristics between the groups in all patients. Subsequently, we stratified the patients into above 35 years of age or younger at the time of ovarian reserve testing.

本研究是针对一个机构数据库的横断面研究。通过超声、腹腔镜或组织学证据诊断子宫内膜异位症的女性作为研究组，余为对照组。首先评估所有患者的人口统计学和临床特征；其次我们在进行卵巢储备评估时，将患者按照年龄35岁以上或年轻组分组研究。

Results

结果

A total of 656 women were included in the final analysis including 71 women with endometriosis. When compared to those without endometriosis, the median AMH and AFC values were significantly lower in the group of women with endometriosis: median 2.1ng/ml; (IQR 1.1-3.9) vs 1.2ng/ml (IQR 0.6-2.4); p<0.001 for AMH and 14 follicles (IQR 8-23) vs 7 follicles (IQR 5-14); p<0.001 for AFC. When stratified, the association between a lower AFC and endometriosis remained significant for both age groups, whereas the association between a lower AMH and endometriosis was only significant in women older than 35 years.

最终分析共纳入656名女性，其中包括71例子宫内膜异位症患者。子宫内膜异位症女性组的中位AMH和AFC值显著低于无子宫内膜异位症患者组：AMH中位数为2.1 ng/ml;（四分位数间距 1.1-3.9) vs 1.2 ng/ml （四分位数间距0.6-2.4)，p<0.001;AFC中位14个（四分位数间距8-23) vs 7个（四分位数间距 5-14)，p < 0.001；当分层时，较低的AFC和子宫内膜异位症之间的相关性在两个年龄组中仍然显著，而较低的AMH和子宫内膜异位症之间的相关性仅在35岁以上的女性中显著。

Conclusions

结论

Our study highlights the endometriosis-detrimental effect and the age enhancement effect of endometriosis on ovarian reserve. Given that many couples begin their family building at an older age and considering the decline in ovarian reserve with aging, exacerbated in the presence of endometriosis, it seems prudent to discuss fertility goals and options including fertility preservations with patients in general, and more importantly with women suffering from endometriosis. At the very least, close follow up and assessment of ovarian reserve should be considered in women with endometriosis.

研究强调了子宫内膜异位症对卵巢储备的不利影响，及年龄对这种影响的增强效应。鉴于许多夫妇在年纪较大的时候开始组建家庭，卵巢储备功能随着年龄增长而下降并因子宫内膜异位症而显著降低。因此对于人群生育目标和生育力保存的讨论和选择需要更谨慎，对于子宫内膜异位症患者，应考虑密切随访和评估卵巢储备。

Impact Statement

影响报告

Detrimental effect of endometriosis on ovarian reserve is further enhanced by increasing age.

子宫内膜异位症对卵巢储备的不利影响随着年龄的增加而进一步增强。

文章来源：

COMBINED EFFECTS OF AGE AND ENDOMETRIOSIS ON OVARIAN RESERVE IN WOMEN WITH INFERTILITYFeferkorn, Ido et al.Fertility and Sterility, Volume 118, Issue 4, e221