经阴道输卵管插管行配子输卵管移植的临床初步研究  

Tubal Catheterization for Transvaginal Gamete Intrafallopian Transfer: an Alternative Technique for Non tubal Infertility

作　　者：陈士岭[1] 邢福祺[1] 宋兰林[1] 陈东红[1] 闫宗合[1] 陈思梅[1] 胡茂兰[1] 

机构地区：[1]第一军医大学南方医院

出　　处：《中华妇产科杂志》1999年第1期8-10,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的了解经阴道配子输卵管移植治疗非输卵管性不孕症（子宫内膜异位症、男性少弱精症、不明原因不孕等）的效果。方法对２１例（２３个周期）不孕症患者分别采用（１）绝经期促性腺激素（ｈＭＧ）／ｈＣＧ（７个周期）；（２）卵泡刺激素（ＦＳＨ）／ｈＭＧ／ｈＣＧ（２个周期）；（３）短方案促性腺激素释放激素激动剂（ＧｎＲＨａ）／ｈＭＧ／ｈＣＧ（２个周期）；（４）长方案ＧｎＲＨａ／ＦＳＨ／ｈＭＧ／ｈＣＧ（１２个周期）进行超促排卵。阴道超声下取卵，经阴道向输卵管内插管注入卵母细胞和精子，用ｈＣＧ或黄体酮维持黄体功能。结果平均每周期植入卵子数为（３３±２１）个（１～８个）；５例妊娠，周期妊娠率为２１７％，其中宫内妊娠４例，输卵管妊娠１例。２例胚胎停止发育，２例继续妊娠已达３０～３４周。结论经阴道配子输卵管移植是一种操作较简单而有效的助孕技术，与经腹腔镜配子输卵管移植相比，价格低廉，无需麻醉，可用于治疗输卵管正常的多种不孕症。Objective To evaluate the outcome of transvaginal gamete intrafallopian transfer (TV GIFT) for infertile patients with non tubal factors. Methods Controlled ovarian hyperstimulation was used for all patients. Transvaginal ultrasound guided oocyte retrieval followed by tubal catheterization for transvaginal gamete intrafallopian transfer of 3.3±2.1 oocytes (range 1～8) and 200 000 sperms in 50 μl culture medium. Results The TV GIFT was used in total of 23 treatment cycles. Of 23 cycles performed for TV GIFT, the procedure was completed easily in 18 and difficult in 5, resulting in 5 clinical pregnancies(21.7% per cycle), 2 of which resulted in abortion, 2 ongoing pregnorncy one was ectopic pregnancy. No pregnancy occurred in four cycles with only one oocyte transferred. Conclusions Simple and cost effective TV GIFT may achieve a higher pregnancy rate. Compared with laparoscopically directed GIFT, tubal catheterization for TV GIFT is safe and less invasive. It is an alternative for non tubal infertility before entering the IVF ET program.

关 键 词：配子移植 输卵管移植 不育症 经阴道插管 

分 类 号：R711.605[医药卫生—妇产科学] R321－33[医药卫生—临床医学]