宫腔镜检查IVF-ET不同妊娠结局的宫腔情况比较和再次妊娠结局分析  

Uterus Cavity Comparison of the Uterine Cavity Condition Among IVF-ET Patients with Different Pregnancy Outcome by Hysteroscopy

作　　者：许思娟[1] 张红红[1] 倪亚莉[1] 白岩[1] 

机构地区：[1]甘肃省妇幼保健院生殖医学中心,甘肃兰州730050

出　　处：《实用妇产科杂志》2013年第5期373-375,共3页Journal of Practical Obstetrics and Gynecology

基　　金：甘肃省科技厅国际合作项目(编号:1011WCGA165)

摘　　要：目的:观察体外受精-胚胎移植(IVF-ET)不同妊娠结局的宫腔情况以及对异常宫腔患者治疗后的再妊娠情况。方法:回顾性分析行宫腔镜检查的582例IVF-ET病例,A组IVF-ET周期前常规宫腔镜检查223例,B组ET后发生异位妊娠18例,C组1次或多次ET未孕225例,D组ET后早期自然流产116例,B、C、D组不良妊娠结局发生后均做宫腔镜检查。比较4组宫腔镜检查的结果,并对发现宫腔异常者进行相应的治疗,观察治疗后的IVF-ET妊娠结局。结果:A组宫腔镜检查宫腔异常率低于B、C、D组(P<0.05),D组中宫腔粘连发生率显著高于A、B、C组(P<0.01)。异常宫腔经治疗后妊娠率46.45%,异位妊娠率3.53%,早孕自然流产率12.94%。结论:对于IVF-ET助孕发生不良妊娠结局的患者,应将宫腔镜检查列为IVF-ET前的常规检查,以提高重复周期的临床妊娠率和着床率,进而提高活胎分娩率。Objective：To investigate the uterus cavity condition of IVF-ET patients with different pregnancy outcome and re-pregnancy rates after therapy with abnormal uterus cavity, Methods：The data of 582 patients underwent hysteroscopy were retrospectively analyzed. The patients were divided into four groups a cording to the reasons for examination：group A（223 patients with examination before IVF-ET cycle）, group B （18 patients with ectopic pregnancy after IVF-ET） ,group C（225 patients with failing to conceive after transfer once or more）, and group D（116 patients with early abortion after transfer）. The hysteroscopic findings were compared among these groups. The clinical outcomes of IVF-ET treatment in the patients undergoing hysteroscopic therapy were evaluated. Results：The positive rate of abnormal hysteroscopic findings in group B,C and D were higher than that in group A（ P〈0. 05）. The incidence of intrauterine adhesion in group D was the highest among 4 groups（ P 〈0. 01 ）. After hysteroscopic treatment the clinicalpregnancy rate was 46.45% ; the ectopic pregnancy rate was 3. 53% ;and the early abortion rate was 12.94 %. Conclusions：The hysteroscopic examination should be routinely used before IVF-ET treatment to improve clinical pregnancy rate and implantation rate, so that to improve live-birth parturition rate.

关 键 词：体外受精-胚胎移植 妊娠结局 宫腔镜 

分 类 号：R711.6[医药卫生—妇产科学]