体外受精/单精子卵胞浆内注射-胚胎移植治疗前宫腔镜手术对妊娠结局的影响  

Effect of hysteroscopy before IVF / ICSI-ET treatment on pregnancy outcome

作　　者：高彦 王媁 冒韵东 朱洪英 穆巧萍 刘嘉茵 

机构地区：[1]南京医科大学第一附属医院生殖医学科,江苏南京210029

出　　处：《现代生物医学进展》2009年第8期1496-1498,1514,共4页Progress in Modern Biomedicine

基　　金：国家863项目子课题(2006AA02Z4A4);973项目子课题(2007CB948103)资助

摘　　要：目的:探讨体外受精/单精子胞浆内注射-胚胎移植(IVF/ICSI-ET)治疗前宫腔镜治疗对妊娠结局的影响。方法:回顾分析2006年1月-2007年12月在本中心接受IVF/ICSI-ET治疗的周期2988个。实验组为在治疗周期前B超或造影检查发现有宫腔病变,或曾有IVF/ICSI-ET失败史而行宫腔镜检查的周期;对照组为未行宫腔镜检查的周期。比较两组妊娠结局的差异。结果:实验组266个周期,第一次行IVF/ICSI-ET治疗前行宫腔镜检查和治疗后妊娠率34.0%(48/141);第二次IVF/ICSI-E治疗前行宫腔镜检查和治疗后妊娠率妊娠率61.7%(21/34);大于等于三次IVF/ICSI-E治疗前行宫腔镜检查和治疗后妊娠率57.6%(15/26);冻胚复苏周期前行宫腔镜检查和治疗后妊娠率53.8%(35/65)。对照组2722例,第一次IVF/ICSI-ET治疗妊娠率43.2%(783/1811);第二次IVF/ICSI-ET治疗妊娠率34.7%(139/400);大于等于三次IVF/ICSI-ET治疗妊娠率28.3%(36/127);冻胚复苏周期治疗妊娠率35.2%(135/384)。两组间妊娠率在IVF/ICSI-ET治疗大于等于二次时有统计学差异(P<0.05)。结论:对于曾有IVF/ICSI-ET治疗失败的患者,拟再次治疗前行宫腔镜检查和治疗对妊娠结局有积极的作用。Objective： To investigate the effect of hysteroscopy before IVF / ICSI-ET treatment on pregnancy outcome. Methods： Retrospective analysis of 2988 cycles receiving IVF / ICSI-ET treatment in our center from January 2006 to December 2007. In the experimental group, intrauterine lesions were found by ultrasound or HSG before IVF / ICSI-ET treatment, or patients had failure histories oflVF / ICSI-ET treatment then received hysteroscopy; Patients who did not receive any hysteroscopy were in the control group. The differences of pregnancy outcome between the two groups were compared. Results： Among 266 cycles in experimental group, the pregnancy rate of the first cycle oflVF / ICSI-ET treatment was 34.0 % （48/141）; the secondary was 61.7% （21/34）; the third and later than third cycle was 57.6 % （15/26）; frozen embryo recovery treatment cycle was 53.8 % （35/65）. Among the 2722 cycles in the control group, the pregnancy rate of the first cycle was 43.2 % （783/1811）; the secondary was 34.7 % （139/400）; the third and later than third cycle was 28.3 % （36/127）; frozen embryo recovery treatment cycle was 35.2% （135/384）. Pregnancy rates had significant difference （P〈0.05） be- tween groups when received secondary and later than secondary IVF / ICSI -ET treatment. Conclusion： With regard to patients who have failure histories oflVF / ICSI -ET treatment, hysteroscopy have positive effect on the outcome of pregnancy.

关 键 词：宫腔镜 IVF/ICSI-ET 妊娠率 

分 类 号：R714[医药卫生—妇产科学]