输卵管积水不同处理方式对体外受精-胚胎移植结局的影响  

Effect of different treatments of hydrosalpinx on in vitro fertilization and embryo transfer

作　　者：陈明高[1] 王丽华[1] 张炎 吴晓明[1] 何健英[2] 邹立波[2] 邹煜[3] CHEN Minggao;WANG Lihua;ZHANG Yan;WU Xiaoming;HE Jianying;ZOU Libo;ZOU Yu(Department of Interventional Radiology, Jinhua Municipal People's Hospital, Jinhua, Zhejiang Province 321000, China)

机构地区：[1]浙江金华市人民医院放射介入科,321000 [2]浙江金华市人民医院医学生殖中心,321000 [3]浙江大学医学院附属妇产科医院放射介入科

出　　处：《介入放射学杂志》2018年第12期1173-1176,共4页Journal of Interventional Radiology

基　　金：浙江省金华市科学技术研究计划项目(2014-3-070).

摘　　要：目的探讨输卵管积水不同的处理方式对体外受精-胚胎移植(IVF-ET)结局的影响。方法对2013年8月至2017年6月因输卵管积水性不孕于2院辅助生殖中心行IVF-ET 260例临床资料进行回顾性分析。按移植前输卵管积水的处理方式分为3组。栓塞组:行介入性输卵管栓塞术(85例);手术组:行输卵管积水腹腔镜造口术或切除术(90例);对照组:移植前未对输卵管积水做任何处理(85例),比较3组患者控制性超排卵(COH)指标及IVF-ET的相关指标,分析输卵管积水不同处理方式对IVFET的影响。结果栓塞组85例患者中,单侧输卵管积水46例,双侧输卵管积水39例,共124条输卵管,栓塞成功124条,总成功率100%。显著有效112条(90.3%);3组患者受精率比较无明显差异(P>0.05),栓塞组和手术组临床妊娠率较对照组明显提高(P<0.05),流产率及异位妊娠率较对照组明显降低(P<0.05)。结论输卵管积水患者行IVF-ET前,栓塞组和手术组处理方法均可以提高IVF-ET临床妊娠率,降低流产及异位妊娠发生率。但介入性输卵管栓塞术更简便、安全、有效,且不影响卵巢的功能,值得临床首选推广应用。Objective To investigate the effect of different treatments of hydrosalpinx on in vitro fertilization and embryo transfer(IVF-ET). Methods The clinical data of 260 infertile female patients due to hydrosalpinx, who received IVF-ET at the Reproductive Medicine Center of Jinhua Municipal Second Hospital, Zhejiang Province, China, during the period from August 2013 to August 2017, were retrospectively analyzed. According to the treatment of hydrosalpinx before transplantation, the patients were divided into three groups: embolization group(receiving interventional embolization of Fallopian tube,n =85), surgical group(receiving laparoscopic ostomy of Fallopian tube or salpingectomy,n=90), and control group(receiving no preoperative treatment for hydrosalpinx,n=85). The controlled ovarian hyperstimulation(COH) indexes and IVF-ET-related indexes were calculated and the results were compared among the three groups. the effects of different treatments of hydrosalpinx on in vitro fertilization and embryo transfer were analyzed. Results Of the 85 patients of embolization group, unilateral hydrosalpinx was detected in 46 and bilateral hydrosalpinx in39, with 124 diseased Fallopian tubes in total. Successful embolization was achieved in all the 124 diseased Fallopian tubes, the total success rate was 100%. Significantly curative effect was obtained in 112 Fallopian tubes(90.3%). No statistically significant difference in fertilization rate existed between each other among the three groups(P>0.05). The clinical pregnancy rates of the embolization group and the surgical group were significantly higher than that of the control group(P<0.05), while the abortion rate and ectopic pregnancy rate were significantly lower than those of the control group(P<0.05). Conclusion In infertile female patients with hydrosalpinx, both interventional embolization of Fallopian tube and laparoscopic ostomy of Fallopian tube or salpingectomy performed before IVF-ET can improve the clinical pregnancy rate, reduce the incidence of abortion and ectop

关 键 词：输卵管积水 介入性输卵管栓塞术 腹腔镜 体外受精-胚胎移植 

分 类 号：R954[医药卫生—药学]