子宫腺肌病年轻不孕患者体外受精/卵胞质内单精子显微注射妊娠结局分析  

Study of pregnancy outcomes after in vitro fertilization/intracytoplasmic sperm injection in young infertile patients with adenomyosis

作　　者：山惠枝 沈晓月[1] 晏媛 王俊霞[1] Shan Huizhi;Shen Xiaoyue;Yan Yuan;Wang Junxia(Reproductive Medicine Center of Nanjing Drum Tower Hospital,Nanjing 210003,China)

机构地区：[1]南京大学医学院附属鼓楼医院生殖医学中心,210003

出　　处：《中华生殖与避孕杂志》2019年第12期1007-1011,共5页Chinese Journal of Reproduction and Contraception

基　　金：国家自然科学基金青年项目(81601346);南京市医学科技发展一般性课题(YKK16084);南京大学中央高校项目(021414380209)。

摘　　要：目的分析年龄<35岁的子宫腺肌病不孕患者行体外受精/卵胞质内单精子显微注射(IVF/ICSI)妊娠结局。方法回顾性分析本中心2014年1月至2017年12月期间于南京大学医学院附属鼓楼医院生殖医学中心行IVF/ICSI治疗并获得临床妊娠的2651例患者的妊娠结局。其中,129例子宫腺肌病合并不孕症患者作为子宫腺肌病组,2522例单纯输卵管因素不孕患者为对照组。结果①两组年龄、不孕年限、体质量指数、基础窦卵泡数、既往生育史比较差异均无统计学意义(P>0.05)。②行IVF的人群中,子宫腺肌病组自然流产率显著高于对照组(13.79%比6.96%,P=0.009);孕周、胎儿体质量、早产率组间比较,差异均无统计学意义(P>0.05)。行ICSI的人群中,子宫腺肌病组与对照组的自然流产率、孕周、胎儿体质量、早产率组间差异均无统计学意义(P>0.05)。③单胎妊娠的子宫腺肌病组自然流产率高于对照组,差异有统计学意义(12.05%比6.31%,P=0.040)。双胎妊娠组中子宫腺肌病组孕周显著小于对照组[(35.68±3.35)周比(36.72±1.99)周,P=0.002],单胎妊娠组中子宫腺肌病组的孕周与对照组间差异无统计学意义(P>0.05);无论单胎妊娠还是双胎妊娠,胎儿体质量和早产率在子宫腺肌病组和对照组间差异均无统计学意义(P>0.05)。④双胎组中,子宫腺肌病患者和对照组的孕周、胎儿体质量均显著低于单胎组(P<0.0001),早产率显著高于单胎组(P<0.0001)。结论对于<35岁的年轻不孕症患者,子宫腺肌病明显增加IVF自然流产的风险,但不增加早产和低出生体质量儿的风险。子宫腺肌病患者和单纯输卵管因素不孕患者中,双胎妊娠均显著增加IVF/ICSI早产和低出生体质量儿的风险。Objective To analyze the pregnancy outcomes of in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)in infertility patients with adenomyosis aged less than 35 years.Methods Retrospective analysis was performed on the pregnancy outcomes of 2651 patients who underwent IVF/ICSI treatment and obtained clinical pregnancy in Reproductive Medicine Center of Nanjing Drum Tower Hospital from January 2014 to December 2017.Among them,adenomyosis group had 129 cases of adenomyosis with infertility patients;control group had 2522 cases of tubal factor infertility patients.Results 1)There were no significant differences in age,infertility duration,body mass index,number of basal sinus follicle and past reproductive histories between the two groups(P>0.05).2)In patients undergoing IVF,the spontaneous miscarriage rate in the adenomyosis group was significantly higher than that in control group(13.79%vs.6.96%,P=0.009).There were no significant differences in gestational age,fetal weight,and preterm delivery rate between the two groups(P>0.05).In patients undergoing ICSI,there were no significant differences in the spontaneous miscarriage rate,gestational age,fetal weight,and preterm delivery rate between the two groups(P>0.05).3)Single pregnancy group and twin pregnancy group were compared respectively.In single pregnancy patients,the spontaneous miscarriage rate in adenomyosis group was higher than that in control group(12.05%vs.6.31%,P=0.040).In twin pregnancy patients,gestational weeks of patients in adenomyosis group were significantly less than those in control group[(35.68±3.35)weeks vs.(36.72±1.99)weeks,P=0.002].There were no significant differences in gestational age in single pregnancy patients between the two groups(P>0.05).There were no statistically significant differences in fetal weight and preterm delivery rates between adenomyosis group and control group,regardless of single or twin pregnancies(P>0.05).4)In twin pregnancy patients,gestational age and fetal weight were significantly lower than those i

关 键 词：受精 体外 胚胎移植 妊娠结局 子宫腺肌病 

分 类 号：R714.8[医药卫生—妇产科学] R711.71[医药卫生—临床医学]