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자궁내막증을 가진 불임환자에서 과배란유도주기에서의 자궁강내 인공수정시 면역요법의 효용성에 관한 연구

The Immunotherapy during Superovaulation with Intraterine Insemination in Infertile Patients with Endometriosis

대한산부인과학회지 1995년 38권 7호 p.1228 ~ 1236
김정훈
조윤경/목정은

Abstract


The present study was designed to determine if the immunotherapy with predinsolone would improve the clinical pregnancy rate in infertile patients with endometriosis who underwent superovulation with intrauterine insemination(IUI). From March
1994
to
March 1995, 51 infertile patients with endometriosis were recruited. They had previously had routine fertility screening, which demonstrated normal semen analyses according to the world Health Organization(WHO) criteria and patent tube(s) with
normal
outline. Twenty-four patients underwent 41 cycles of superovulation with IUI, receiving corticosteroids. Twenty-seven patients who underwent 48 superovulation with IUI cycles served as controls, not receiving corticosteroids. There were no
significant
differences between treatment group and control group in the clinical response to superovulation. There was a significantly higher clinical pregnancy rate per cycle in treatment group, with 45.3%(19/41) compared with 25.%(12/48) in control group
but no
differences between two groups in abortion rate and multiple pregnancy rate per clinical pregnancy. In patient subgroup of stage I or II endometriosis, there was no difference between two groups. in a clinical pregnancy rate per cycle(52.4% vs
32.0%).
In both patient subgroups of stage III or IV endometriosis and positive autoantibodies, clinical pregnancy rates per cycle were higher in treatment groups, than those in control groups but differences were not statistically significant (40.0% vs
17.4%;
36.4% vs 16.7%). There were no side-effects due to the use of corticosteroids. This study suggests that immunotherapy with corticosteroids could improve the clinical pregnancy rate in endometriosis patients undergoing superovulation with IUI and
may be
more effective in patients with advanced stage of endometriosis and positive autoantibodies.

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