取卵后引流输卵管积水对体外受精-胚胎移植结局的影响  

Analysis of puncture suction of hydrosalpinx after collecting oocytes with pregnancy outcome of IVF

作　　者：谭丽[1] 董方莉[1] 项云改[1] 赵冬梅[1] 黄玉荣[1] 马丽影[1] 

机构地区：[1]郑州大学第二附属医院生殖医学中心,河南郑州450014

出　　处：《中国实用妇科与产科杂志》2009年第3期220-222,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨取卵后穿刺抽吸输卵管积水对体外受精-胚胎移植(IVF-ET)临床结局的影响。方法回顾分析2003年1月至2008年6月期间郑州大学第二附属医院生殖中心145例患者因输卵管因素而行IVF-ET157个周期的资料。根据子宫输卵管造影(HSG)和阴道超声诊断积水及处理方法的不同分为3组。A组:22例,HSG和阴道超声均可见输卵管积水,取卵后同时抽吸积水;B组:24例,HSG见积水,但阴道超声未见明显的积水,取卵时不穿刺积水;C组:111例,单纯输卵管阻塞不伴积水者,设为对照组。结果各组间的妊娠率、植入率、流产率差异无统计学意义(P>0.05)。A组的受精率高于C组,差异有统计学意义(P<0.05)。积水组(A、B组)的流产率略高于无积水组(C组),但差异无统计学意义(P>0.05)。B组的异位妊娠率高于A组和C组,但差异无统计学意义(P>0.05)。结论对阴道超声可见的输卵管积水取卵后抽净积水,可取得与无输卵管积水患者相近的临床结局。HSG提示积水而阴道超声未显示积水,患者无阴道排液者(B组),对IVF-ET的临床结局影响不大,无需特殊处理。Objective To analyse the pregnancy outcome after collecting oocyte with puncture suction of hydrosalpinx in IVF. Methods Analyze retrospectively 157 cycles of information concerning 145 cases of tubal factors to IVF-ET cycle from January 2003 to June 2008 in Reproductive Centre the Second Affiliated Hospital of Zhengzhou University. According to hysterosalpingography （HSG） and transvaginal ultrasound diagnosis and different ways to treat hydrosalpinx, the patients could be divided into three groups, A, B and C. Group A （22 cycles） ： When hydrosalpinx was visible in both HSG and transvaginal ultrasound, pump water after collecting oocyte. Group B （24 cycles） ： When hydrosalpinx was visible in HSG, but it was not obvious in transvaginal ultrasound, do not puncture water while collecting oocyte. Group C （ 111 cycles） ： Tubal occlusion without hydrosalpinx, set up as the control group. Results The pregnancy rate, implantation rate and abortion rate was no statistical difference among all groups （P 〉 0. 05）. The fertilization rate of Group A was higher than that of Group C, which was a significant difference （P 〈 0.05）. The abortion rate of Group A and B was slightly higher than that of Group C, but the difference being not statistically significant （ P 〉 0. 05 ）. The ectopic pregnancy rate of Group B was higher than that of Group A and Group C, the difference being not significant （ P 〉 0. 05 ）. Conclusions Pumping the transvaginal ultrasound-visible hydrosalpinx after collecting oocyte can avoid the damage of the toxicity to the embryo and endometrial receptivity and help to get better clinical outcomes. Patients （Group B） who have no vaginal discharge stagnant water, but HSG stagnant water not shown by ultrasound have less effect on the clinical outcomes of IVF-ET, thus do not need special treatment.

关 键 词：输卵管积水 体外受精-胚胎移植 临床结局 

分 类 号：R71[医药卫生—妇产科学]