宫腔镜下宫腔粘连分离术后行体外受精-胚胎移植的妊娠结局及影响因素  

Pregnancy Outcomes and Influence Factors in Patients with IVF-ET after Hysteroscopic Transcervical Resection of Adhesion

作　　者：何均 刁红录 张昌军 胡玥玥 HE Jun;DIAO Honglu;ZHANG Changjun(Hubei Medical University Postgraduate Training Base united,Jinzhou Medical University,Shiyan Hubei 442000,China;Shiyan People's Hospital(The Hospital Affiliated to Hubei Medical University,Reproductive Medicine Center),Shiyan Hubei 442000,China)

机构地区：[1]锦州医科大学湖北医药学院研究生培养基地,湖北十堰442000 [2]十堰市人民医院(湖北医药学院附属人民医院)生殖医学中心,湖北十堰442000

出　　处：《实用妇产科杂志》2019年第12期941-944,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:分析不孕症合并宫腔粘连(IUA)患者在宫腔镜下行宫腔粘连分离术(TCRA)后行体外受精-胚胎移植(IVF-ET)的妊娠结局及相关影响因素。方法:选择2016年3月至2017年8月就诊于湖北医药学院附属人民医院生殖医学中心行宫腔镜检查的不孕患者,行IVF-ET助孕治疗的临床资料及妊娠结局,根据宫腔情况分为对照组:正常宫腔形态行IVF-ET助孕患者425例;IUA组:IUA经TCRA治疗后行IVF-ET助孕患者119例。比较两组患者一般资料及妊娠结局,分析影响术后妊娠的相关因素。结果:IUA组的临床妊娠率、活产率较低,流产率较高,但差异无统计学意义(P>0.05)。根据年龄、BMI、流产次数、粘连程度分组比较,临床妊娠率差异有统计学意义(P<0.05);多因素Logistic回归分析显示:年龄(≥35岁)、流产次数(≥3次)、粘连程度(中、重度)及BMI(≥24 kg/m^2)是影响TCRA术后妊娠结局的独立危险因素。结论:不孕症合并IUA患者,TCRA术后行IVF-ET助孕治疗的临床妊娠率接近于正常宫腔形态患者,年龄、粘连程度、流产次数及BMI是影响术后妊娠结局的主要因素。Objective:To analyze the pregnancy outcomes and influence factors in infertile patients with intrauterine adhesions(IUA)treated by in vitro fertilization-embryo transfer(IVF-ET)after hysteroscopic transcervical resection of adhesion(TCRA).Methods:The clinical data and pregnancy outcomes of infertility patients with IUA were collected from March 2016 to August 2017 in the reproductive medicine center in Renmin hospital of Hubei University of Medicine.According to the condition of uterine cavity,the patients were divided into two groups.425 cases with normal uterine cavity were the control group.119 cases with IUA treated by TCRA were IUA group.The general data and pregnancy outcomes of two groups were compared,and the factors influencing postoperative pregnancy were analyzed.Results:The clinical pregnant rate and live birth rate were lower,while the abortion rate was higher in the IUA group than those in the control group,but there were no significant statistically difference(P>0.05).According to the age,BMI,times of abortion and degree of adhesion,there was significant difference in clinical pregnancy rate in two groups(P<0.05).Multivariate logistic regression analysis showed that age(≥35years),times of abortion(≥3 times),degree of adhesion(moderate or severe)and BMI(≥24 kg/m^2)were the independent risk factors of pregnancy outcomes after TCRA.Conclusions:The pregnancy rate of infertile patients with IUA who were assisted by IVF-ET after TCRA was closed to the patients with normal uterine cavity.Age,adhesion degree,frequency of abortion and BMI were the main factors influencing pregnancy outcomes after TCRA.

关 键 词：宫腔粘连 宫腔粘连分离术 体外受精-胚胎移植 妊娠结局 影响因素 

分 类 号：R711.74[医药卫生—妇产科学]