体外受精-胚胎移植失败后行检查性宫腔镜的应用价值  

Application of Diagnostic Hysteroscopy in Women Failed to Conceive after the Treatment of in Vitro Fertilization-Embryo Transfer

作　　者：徐兰萍[1] 

机构地区：[1]武汉大学人民医院生殖医学中心,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2009年第2期269-271,共3页Medical Journal of Wuhan University

摘　　要：目的:探讨检查性宫腔镜在助孕治疗失败后要求再次进行体外受精-胚胎移植(IVF-ET)的患者中的应用价值。方法:回顾性分析曾行IVF-ET失败要求再次行IVF-ET患者159例,根据是否在第2次IVF-ET前接受宫腔镜检查分为A、B两组,根据宫腔镜检查情况将A组分为宫腔形态正常组(A1组)与宫腔形态异常组(A2组),分析A组宫腔镜检查情况,并比较在A1组、A2组和B组在重复IVF-ET周期中优质胚胎率、着床率、临床妊娠率。结果:宫腔镜检查53.8%宫腔形态正常,46.2%发现宫腔内微小病变,包括子宫内膜息肉、子宫内膜炎、宫腔轻度粘连、子宫黏膜下肌瘤、子宫内膜增殖和子宫内膜发育不良;经过宫腔镜检查后的A组临床妊娠率与着床率明显较未行宫腔镜检查的B组高,A1组临床妊娠率和着床率较B组低,但其结果无统计学差异;A2组临床妊娠率和着床率显著高于B组。结论:宫腔镜可以发现存在于宫腔内的微小病变;IVF-ET失败患者应放宽宫腔镜检查指征,以提高重复周期的临床妊娠率和着床率。Objective： To assess hysteroscopic findings in patients undergoing IVF-ET who repeatedly failed to conceive despite transferring of good-quality embryos. Methods： A total of 159 patients who had experienced failure IVF-ET cycles were divided into two groups according to whether accepting hysteroscopy before the repeated cycle. Group B （n=68） did not have office hysteroscopy. Group A （n=91） had office hysteroscopy and was sub-classified into Group A1 and Group A2. Group A1 （n=49） had normal hysteroscopic findings whereas Group A2 （n=42） had abnormal office hysteroscopy findings. The rates of good quality embryos, implantation rates and clinical pregnancy rates were compared among these groups, Results： 53.8% patients of Group A1 had normal hysteroscopic findings and 46.2 % cases of Group A2 had abnormal hysteroscopy findings such as endometrial polyps, endometritis, intrauterine adhesion, etc. There was no difference in the mean number of oocytes retrieved, fertilization rate, and number of embryos transferred among different groups. Statistical difference was observed in terms of clinical pregnancy rates and implantation rates between Group A and Group B. Conclusion： Patients with IVF embryo transfer failures after normal hysterosalpingography findings should be re-evaluated using hysteroscopy prior to further commencing IVF-embryo transfer cycles in order to enhance theclinical pregnancy rates.

关 键 词：体外受精-胚胎移植 着床失败 宫腔镜 

分 类 号：R713.7[医药卫生—妇产科学]