不孕症合并瘢痕子宫患者胚胎解冻移植周期妊娠结局分析  

Analysis of the outcome of pregnancy patients with scar uterine in the cycle of frozen-thawed embryo transfer

作　　者：郭培培[1] 余照娟 黄苗苗[1] 向卉芬[1] 曹云霞[1] 魏兆莲[1] 

机构地区：[1]安徽医科大学第一附属医院妇产科生殖医学中心,合肥230022

出　　处：《安徽医科大学学报》2017年第12期1876-1879,共4页Acta Universitatis Medicinalis Anhui

基　　金：卫生行业科研专项项目(编号:201402004)

摘　　要：目的探讨不孕症合并瘢痕子宫(剖宫产术后)患者行胚胎解冻移植(F-ET)后妊娠结局及剖宫产后子宫切口憩室(PCSD)对F-ET妊娠结局的影响。方法回顾性分析行F-ET助孕的瘢痕子宫(剖宫产术后)309个周期(瘢痕子宫组),按年龄匹配,随机选取同期行F-ET的因输卵管因素不孕非瘢痕子宫309个周期(对照组),PCSD组(n=67),无PCSD(NPCSD)组(n=242),分别比较3组胚胎种植及妊娠结局等。结果单胚胎移植(SET)周期3组种植率及临床妊娠率差异无统计学意义。双胚胎移植(DET)PCSD组胚胎种植率及临床妊娠率均低于NPCSD组及对照组,差异有统计学意义(P<0.05)。NPCSD组及对照组在DET及三胚胎种植率、临床妊娠率均差异无统计学意义。3组在不同的移植胚胎数目时胚胎种植率、临床妊娠率均差异无统计学意义。3组患者SET后均无多胎妊娠发生,NPCSD组及对照组患者移植3枚胚胎时多胎妊娠率较DBT时增高,但差异无统计学意义。3组患者流产率及双胎活产率均差异无统计学意义。PCSD组患者报婴回家率低于其他两组(P<0.05)。结论 SET可在不降低胚胎种植率的前提下有效降低多胎妊娠率。PCSD影响胚胎种植率、临床妊娠率、报婴回家率,但不影响流产率。Objective To observe the pregnancy outcome of the patients with scar uterine（ after cesarean section）and the effect of the previous cesarean section defect（ PCSD） on the pregnancy outcome in the frozen-thawed embryo transfer cycle. Methods A retrospective analysis was made including 309 F-ET cycles with scar uterine（PCSD group n = 67,NPCSD n = 242） and 309 F-ET cycles with tubal factor infertility in the same period. Then compared the condition of embryo implantation and the pregnancy outcome among the three group. Results There were no significant differences in embryo implantation rate（ IR） and clinical pregnancy rate（ PR） among the three group of single embryo transfer cycles. The PR and IR in the PCSD group were significantly lower than NPCSD group and control group respectively in the double embryo transfer cycles（ P〈0. 05）. There were no significant differences in embryo IR and PR among the three group when the embryos numbers were different. Patients in the three group had no mutiple pregnancy after single embryo transfer（ SET）. Patients in the NPCSD group and control group had higher rate of mutiple pregnancy,but there was not significant difference. There were no significant differences in miscarriage rate and twins live birth rate among the three group. The rate of take baby home in the PCSD group were lower than those in NPCSD group and control group,respectively（ P〈0. 05）. Conclusion SET may reduce multiple pregnancy rate effectively on the premise of affecting the IR. PCSD reduces the IR,PR,take baby home rate,excluding the miscarriage rate.

关 键 词：胚胎解冻移植 剖宫产 子宫切口憩室 妊娠结局 

分 类 号：R715.5[医药卫生—妇产科学]