子宫肌壁间肌瘤对体外受精-胚胎移植结局影响  

Intramural leiomyoma affect the outcome of in vitro fertilization and embryo transfer

作　　者：李佳宁[1] 马彩虹[2] 范玲[1] 乔杰[2] 

机构地区：[1]首都医科大学附属北京妇产医院,北京100026 [2]北京大学第三医院生殖医学中心,北京100191

出　　处：《中国实用妇科与产科杂志》2014年第3期189-191,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨子宫肌壁间肌瘤在不影响宫腔形态以及内膜形状时对体外受精-胚胎移植(IVF-ET)结局的影响。方法采用回顾性队列研究分析方法,对北京大学第三医院生殖医学中心2006年8月至2009年8月子宫肌壁间肌瘤并通过超声检查或宫腔镜检查除外内膜病变以及宫腔形态异常病例156例,共行200个IVF-ET周期,为研究组;同期不合并子宫肌瘤的病例中按年龄与取卵数配对随机选择200个周期作为对照组。比较两组之间的临床妊娠率、胚胎着床率、活产率和自然流产率。结果研究组临床妊娠率为26%(52/200),对照组为34%(68/200),差异无统计学意义(P=0.103);研究组活产率低于对照组[19%(38/200)vs.27.5%(55/200)],差异有统计学意义(P=0.043)。子宫肌壁间肌瘤径线之和≥4 cm时临床妊娠率(17.3%vs.36.5%,P=0.027)和胚胎着床率(10.1%vs.19%,P=0.04)与对照组比较显著降低。结论子宫肌壁间肌瘤降低IVF-ET的活产率,在肌瘤径线之和≥4 cm时胚胎着床率以及临床妊娠率降低。Objective To investigate the impact of intramural uterine fibroids without endometrial cavity distortion on the outcome of in vitro fertilization embryo transfer（IVF-ET）. Methods Data were collected by retrospective review of patients with intramural uterine fibroids in Center for Reproductive Medicine of Peking University Third Hospital, 400 consecutive IVF cycles with fresh embryo transfer performed between August 2006 and August 2009. 200 cycles with intramural uterine leiomyomas that do not distort the endometrial cavity discovered on initial routine screening transvaginal sonography （TVS） performed in preparation for IVF-ET （study group） were retrospectively matched by age and number of collected oocytes with other 200 patients at the same period of treatment who did not demonstrate fibroids anywhere in the uterus （control group）. Results （1）The live birth rate in fibroid group was lower significantly than that in control group, （ 19% vs. 27.5% ,P =0. 043） ;there was also a trend for lower clinical pregnancy rate in study group（26% vs. 34% ,P = 0. 103 ,NS）. （2）The subgroup with bigger fibroids （ 〉 4 cm）got a significantly lower clinical pregnancy rate and implantation rate. Conclusion The negative impact of intramural fibroids that do not distort the endometrial cavity on IVF-ET outcomes was clearly existed and mainly in the cases with larger fibroids（ ≥4 cm）.

关 键 词：体外受精-胚胎移植 子宫肌壁间肌瘤 临床妊娠率 胚胎着床率 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]