冷冻胚胎移植前应用宫腔镜检查联合子宫内膜轻创术的意义  

The Effect of Hysteroscopic Examination and Endometrial Local Injury on the Outcome of Frozen Embryo Transfer

作　　者：庄燕燕[1] 夏飞[1] 周卫琴[1] 何琦[1] 茅彩萍[1] 华月琴[1] 吴志南[1] 

机构地区：[1]苏州大学附属第一医院生殖医学中心,江苏苏州215006

出　　处：《实用妇产科杂志》2015年第7期520-523,共4页Journal of Practical Obstetrics and Gynecology

基　　金：苏州市"科教兴卫"青年科技基金资助(编号:kjxw2014005)

摘　　要：目的:探讨宫腔镜检查联合子宫内膜轻创术对冷冻胚胎移植(FET)后的临床妊娠结局的影响。方法:选择2013年3月至2014年3月行FET治疗的不孕患者165例为研究对象,其中在FET前行宫腔镜检查联合子宫内膜轻创术95例为宫腔镜组,直接行FET治疗的70例为对照组。比较两组的临床妊娠率、胚胎种植率和不良妊娠率(包括早期流产、胚胎停育、异位妊娠);并对宫腔镜组中宫腔镜检查结果正常与异常(子宫内膜炎、子宫内膜息肉及增生、宫腔粘连)患者的临床妊娠结局进行比较。结果:宫腔镜组的临床妊娠率(57.89%)、胚胎种植率(38.51%)明显高于对照组(42.86%、26.15%),差异有统计学意义(P<0.05);两组不良妊娠率比较,差异无统计学意义(P>0.05)。宫腔镜组中宫腔异常的发生率为50.53%,宫腔异常组中各种类型患者经治疗后的临床妊娠率、胚胎种植率分别与宫腔正常组比较,差异均无统计学意义(P>0.05)。结论:宫腔镜检查联合子宫内膜轻创术可以提高FET周期的临床妊娠率、胚胎种植率。宫腔异常的患者经宫腔镜治疗后可改善子宫内膜的容受性。Objective： To analyze the effect of hysteroscopic examination and endometrial local injury on the incidence of successful pregnancy in patients undergoing frozen embryo transfer（FET）. Methods：Data from 165 patients were retrospectively analysed. 95 cases（treatment group）were operated hysteroscopic examination and endometrial local injury. The remaining 70 untreated patients served as control. Evaluate the rates of clincal preg- nancy, embryo impantation and adverse pregnancy between two groups and analyse the pregnancy outcome in different hysteroscopic results. Results： The rates of clinical pregnancy, embryo implantation in the treatment group were 57. 89%, 38. 51%, respectively, which were significantly higher than those in the control group （42.86% ,26. 15%）. The rates of adverse pregnancy of the two groups had no statistically significant differences. The incidences of hysteroscopic abnormalities were 50. 53%. After hysteroscopic treatment the rates of clinical pregnancy, embryo implantation had no significant differences between normal and abnormalities groups. Conclusions：Hysteroscopic examination and endometrial local injury significantly improves the sucessful pregnancy in patients undergoing frozen embryo transfer. Endometrial receptivity can be improved after treatment in patients with hysteroscopic abnormalities.

关 键 词：冷冻胚胎移植 宫腔镜 子宫内膜轻创术 内膜容受性 

分 类 号：R714.8[医药卫生—妇产科学]