先天性子宫畸形患者辅助生殖技术助孕结局分析  

Analysis of the obstetric outcome of assisted reproductive techniques in women with congenital uterine malformation

作　　者：冯彦琴[1] 苏迎春[1] 孙莹璞[1] 郭艺红[1] 王芳[1] 董方莉[1] 

机构地区：[1]郑州大学第一附属医院生殖医学中心,郑州450052

出　　处：《现代妇产科进展》2013年第4期302-305,309,共5页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨先天性子宫畸形对女性生育能力的影响及先天性子宫畸形患者行辅助生殖技术(ART)助孕后的妊娠情况。方法:回顾分析我院2004年1月至2011年6月收治的145例子宫畸形行体外受精/卵胞浆内单精子显微注射和胚胎移植(IVF/ICSI-ET)患者的临床资料。随机抽取同期子宫形态正常的不孕患者198例作为对照组,比较两组患者的助孕情况及妊娠结局。结果:(1)子宫畸形组的年龄、获卵数、移植胚胎数、子宫内膜厚度与对照组比较,均无统计学差异;(2)145例子宫畸形患者行248个胚胎移植周期,妊娠89例共96个周期,患者临床妊娠率61.38%(89/145),移植周期临床妊娠率38.71%(96/248),足月产占55.21%(53/96)。与对照组比较,不同类型子宫畸形组临床妊娠率、多胎妊娠率、平均孕周及新生儿出生体重差异均无统计学意义;(3)双角+双子宫流产率较高(43.75%),与对照组比较差异显著(P<0.05),其余各组差异均无统计学意义;(4)子宫畸形组的胎膜早破及低出生体重儿发生率分别为20.29%、31.87%,均显著高于对照组(P<0.05)。结论:先天性子宫畸形患者行ART助孕后妊娠率良好,但妊娠期胎膜早破及低出生体重儿发生率明显增高。Objective ： To evaluate the impact of congenital uterine anomalies on women fertility and the reproductive performance of women with congenital uterine anomalies who underwent in vitro fertilization （IVF） or intracytoplasmie sperm injection （ICSI）. and embryo transfer （ET）. Methods：Clinical data of 145 infertile patients with uterine anomalies who un- derwent assisted reproductive techniques（ART） from Jan. 2004 to June 2011 were studied retrospectively. 198 infertile patients with normal uterus were randomly selected as control group during the same period. Results ： （ 1 ） There were no statistical difference in age, number of oocytes retrieved, number of embryos transfered and the thickness of endometrium between the study group and the control group. （2） Eighty-nine patients conceived a total of 96 clinical pregnancies in 248 embryo transfer cycles. The clinical pregnancy rate was 89 of 145 （61.38%） per patient and 96 of 248（38.71% ） per embryo transfer. The full term birth rate was 55.21% （53/96）. There were no significant differences in the clinical pregnancy rates, multiple pregnancy rate, gestational age, weight of newborn among various forms of uterine malformation and the control group. （3）Women with bicornuate or didelphic uteri had higher miscarriages than normal group （ P〈0.05 ）. But there were no difference in the other subtypes. （4） Compared with control group, patients with uterine malformation had higher incidence of the premature rupture of membranes and lower birth weight（ P〈0.05 ）. Conclusion：ART in women with congenital uterine malformation is associated with good ture rupture of membranes and lower birth pregnancy rates, but higher incidence of the prema- weight.

关 键 词：子宫畸形 不孕 体外受精 胚胎移植 妊娠 

分 类 号：R711.6[医药卫生—妇产科学]