辅助生殖技术中异位妊娠的发生率及影响因素  

Incidence of ectopic pregnancy in assisted reproductive technology and its influence factors

作　　者：王惠[1] 曲绪琴[1] 张倩[1] 王冬梅[1] 孙雪艳[1] 

机构地区：[1]山东省烟台市烟台山医院生殖中心,山东烟台264003

出　　处：《实用医院临床杂志》2016年第6期57-60,共4页Practical Journal of Clinical Medicine

摘　　要：目的分析应用辅助生殖技术(assisted reproductive technology,ART)后异位妊娠(ectopic pregnancy,EP)的发生率、影响因素,并对早期诊疗与防治进行探讨。方法选择2001年12月至2015年12月在我院接受ART助孕治疗的妇女4996个周期,其中获得妊娠的2112例,包含EP74例。根据ART方法将全部4996个周期分为3组(IVF-ET组,2514例;ICSIET组,1424例;FET组,1058例),对不同助孕方式EP发生率进行统计。将获得妊娠的2112例分作新鲜移植周期组(1660例)和冻胚移植周期组(452例),分析两组间EP发生率是否存在差异。然后将EP组(74例)作为观察组,宫内妊娠组(2038例)作为对照组,进行两组间EP发生单因素分析。采用Logistic回归性分析ART后EP发生的影响因素。结果 ICSI-ET组和FET组间EP发生率差异无统计意义,而IVF-ET组EP发生率显著高于ICSI-ET组和FET组(均P<0.05);新鲜周期发生EP的比例显著高于冻融周期(P<0.05);根据Logistic回归性分析,将ART后EP发生作为因变量,将其他因素作自变量,得到6个影响EP发生率的因素,即:原发不孕、既往盆腔手术史、输卵管盆腔因素、排卵障碍、移植日内膜厚度以及子宫内膜异位症及术后。结论 IVF-ET周期EP发生率显著高于ICSI-ET和FET,而后两组间EP发生率差异无统计意义。新鲜周期发生EP的比例显著高于冻融周期。既往盆腔手术史、既往EP史、移植日内膜厚度、输卵管盆腔因素、排卵障碍以及子宫内膜异位症及术后是ART发生EP的危险因素,临床治疗应予以注意,以降低EP的发生率。Objective To analyze the incidence and influence factors of ectopic pregnancy （ EP） after the application of assis-ted reproductive technology （ ART） and to explore the early diagnosis and treatment of ectopic pregnancy.Methods We selected 4996 cycles who received ART to help pregnancy in our hospital from December 2001 to December 2015.Of these cycles,2112 cases were pregnant including 74 EP cases.First at al,total 4996 cycles were divided into IVF-ET group （n =2514）,ICSI-ET group （n =1424） and FET group （n =1058） according to the method of ART.The incidence of EP in different groups was statistically analyzed. Secondly,for 2112 cases of pregnancy,the incidence of EP was compared between fresh cycles group （ n =1660） and freeze thaw cy-cles group （n =452）.Finally,we took EP （n =74） as observation group and uterine pregnancy （n =2038） as control group.The single factor analysis and multiple logistic regression analysis were used to analyze the influence factors of EP.Results There was no difference in the incidence of EP between the ICSI-ET and FET groups,while the prevalence of EP in the IVF-ET group was significant-ly higher than that in the ICSI-ET and FET groups （P〈0.05）.The proportion of EP in the fresh cycle groups was significantly higher than that in the freezing thawing cycle groups （P〈0.05）.There were 6 factors including primary infertility,previous history of pelvic surgery,fallopian tube pelvic factors,ovulation disorders,transplant the endometrial thickness and endometriosis and operation were in-fluence factors for EP according to logistic regression analysis when EP incidence was used as dependent variable and other factors were used as the independent variables.Conclusion The incidence of EP in IVF-ET was significantly higher than that in ICSI-ET and FET,but there is no difference between the ICSI-ET and FET.The incidence of EP in fresh cycles was significantly higher than that in freeze thaw cycles.In clinic,the incidence of EP is reduced by the ear

关 键 词：输卵管生殖技术 异位妊娠 发生率 影响因素 

分 类 号：R711.6[医药卫生—妇产科学]