不孕症女性生育镜检查结果分析  

Clinical analysis of outcomes of fertiloscopic examination for infertile women

作　　者：张琬琳 王鑫 谢多 刘瑾 肖西峰 Zhang Wanlin;Wang Xin;Xie Duo;Liu Jin;Xiao Xifeng(Reproductive Medical Center, Department of Gynecology and Obstetrics, the Second Filiated Hospital of the Fourth Military Medical University, Xi'an 710038,China;Department of Gynecology and Obstetrics of the 323 Military Hospital, Xi'an 710054, China)

机构地区：[1]空军军医大学第二附属医院妇产科生殖医学中心,西安710038 [2]解放军323医院妇产科,西安710054

出　　处：《中华生殖与避孕杂志》2019年第5期394-398,共5页Chinese Journal of Reproduction and Contraception

摘　　要：目的探究生育镜在查找不孕症病因、指导进一步助孕方面的作用。方法本文回顾了空军军医大学唐都医院生殖医学中心2014年7月—2018年4月期间487例生育镜检查结果,并对其中216例患者的妊娠结局进行了随访。对检查结果的分布频率进行描述性统计,对不同年龄组及不同不孕症诊断组的检查结果分布进行χ2检验。结果487例生育镜检查术成功率100%,无并发症发生。所有患者均可耐受手术。在所有检查结果中,双侧或单侧输卵管通畅且不合并其他异常者185例(38.0%);双侧或单侧输卵管通畅且仅合并可纠正宫腔异常者118例(24.2%)。有2种或2种以上解剖异常者所占比例(62%)大于仅有1种或1种以下解剖异常者(38%)。随访的216例患者中,生育镜检查距妊娠的时间间隔为(8.15±3.14)个月(1~35个月)。总体活产率为54.6%(118/216),继续妊娠率为10.2%(22/216),流产率为6.5%(14/216),未妊娠率为28.7%(62/216)。在活产者中,至少一侧输卵管通畅者通过自然方式妊娠的比例[77.0%(97/126)]高于通过体外受精-胚胎移植术妊娠的比例[23.0%(29/126)](P<0.001)。结论生育镜是评估女性上生殖道解剖的一种全面、安全、痛苦小及便捷的检查方法。对于任何年龄、无论原发或继发不孕的患者,若无明确盆腹腔病史,生育镜检查可在查找不孕原因、指导进一步治疗方面使大多数患者获益。Objective To explore the implication of fertiloscopy in screening the etiology of female infertility and tailoring the treatment method for an individual infertile woman. Methods This article retrospectively analyzed the outcomes of fertiloscopic examination for 487 infertile women in the Reproductive Medical Center of Tangdu Hospital from June 2014 to April 2018. The frequency distribution of the examination outcomes was presented descriptively by numbers and percentages. The discrepancies of frequency distribution between groups of different ages and infertility diagnosis were examined with chi-square test. Results The success rate of the examination was 100%. No complication occurred. The procedures were all tolerable. In all outcomes of the examination, there were 118 cases (24.2%) with normal uterine cavity, normal bilateral patent tubes and without other anomalies;67 cases (13.8%) with normal uterine cavity, unilateral patent tube and without other anomalies, and 8 cases (1.6%) with normal uterine cavity, bilateral obstructive tubes and without other anomalies. In groups of age younger than 30 years old and age of 30 years old or older, in groups of primary infertility and secondary infertility, the proportion of cases with at least one patent tube without other anomalies (38%) was significantly lower than cases with 2 or more anomalies (62%). Among 216 patients who were followed up, the average interval between fertiloscopic exmaination and pregnancy was (8.15±3.14) months (1-35 months). The overall live birth rate was 54.6%(118/216), the ongoing pregnancy rate was 10.2%(22/216), the miscarriage rate was 6.5%(14/216), and there was 28.7%(62/216) patients who hadn’t gotten pregnant at the time of data collection. The proportion of live births through natural intercourse [77.0%(97/126)] was significantly higher than that through in vitro fertilization-embryo transfer [23.0%(29/126)] in patients with at least one patent fallopian tube (P<0.001). Conclusion For selected infertile women, fertiloscopy is a co

关 键 词：不孕症 生育镜 经阴道注水腹腔镜 

分 类 号：R711.6[医药卫生—妇产科学]