输卵管积水对新鲜胚胎移植和冻融胚胎移植妊娠结局的影响  

Effects of hydrosalpinx on the clinical outcome of fresh embryo transfer and frozen-thawed embryo transfer

作　　者：朱颖 马丽影[1] 毛跟红[1] 谭丽[1] Zhu Ying;Ma Liying;Mao Genhong;Tan Li(Reproductive Medical Center,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450014,P.R.China)

机构地区：[1]郑州大学第二附属医院生殖中心,河南郑州450014

出　　处：《中国计划生育和妇产科》2022年第2期29-33,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：河南省科技惠民计划项目(项目编号:2019KJHM0009)。

摘　　要：目的探讨输卵管积水对体外受精新鲜胚胎移植和冻融胚胎移植临床结局的影响。方法回顾性分析2017年1月至2020年6月因输卵管因素在郑州大学第二附属医院生殖中心行常规体外受精-胚胎移植(in vitro fertilization and embryo transfer, IVF-ET)治疗的496例不育患者的资料,按IVF-ET前患者输卵管积水的发生和移植情况分为:A组无积水组并新鲜胚胎移植181例;B组新鲜胚胎移植当天行输卵管积水抽吸术51例;C组因输卵管积水行胚胎冷冻,积水治疗后首次复苏移植,根据复苏距离取卵时间分为C1(≤1年)136例,C2(>1年)84例;D组为暂行胚胎冷冻,复苏移植当日行积水抽吸术44例。比较各组妊娠结局。结果 A组的临床妊娠率(69.1%)明显高于B组(54.9%)和C、D组(55.0%和54.5%)(P<0.05),A组的种植率(41.9%)也高于其他组(B组34.5%,C组33.0%,D组32.9%)(P<0.05),获卵数A组(9.4±6.1)低于其他各组(P<0.05),多胎妊娠率A组(15.2%)高于B组(3.9%),受精率、移植胚胎数和异位妊娠率各组间比较,差异无统计学意义(P>0.05)。C1组的临床妊娠率(53.7%)和胚胎着床率(31.2%)低于C2组(57.1%和35.7%),但差异无统计学意义(P>0.05),C2组的多胎妊娠率高于C1组(P<0.05),余控制性超排方案基础数据在各亚组之间无统计学意义(P>0.05)。结论输卵管积水影响IVF-ET的临床妊娠率和着床率,积水抽吸对新鲜胚胎和冻融胚胎移植妊娠结局并无明显差异。因积水行胚胎冷冻者,积水治疗后1年内行冻融胚胎移植者着床率略低于治疗后≥1年移植者,此差别虽无临床统计学意义,可指导临床进行积水抽吸处理进行改善或暂行胚胎冷冻。Objective To evaluate the impact of hydrosalpinx on the clinical outcome of fresh embryo transfer and frozen-thawed embryo transfer(FET).Methods The data of patients of oviduct infertile undergoing IVF-ET were retrospectively analyzed from January 2017 to June 2020 in Reproductive Center of the Second Affiliated Hospital of Zheng Zhou University.Subjects were divided according to different approaches of hydrosalpinx aspiration and tranfer.Patients with obstruction of fallopian tube and fresh embryo transfer(without hydrosalpinx)were taken in Group A as negative control(n=181).Group B were consisted by patients undergoing hydrosalpinx aspiration on fresh embryo transfer day(n=51).Patients in group C had their embryoes frozen and FET after certain treatment of hydrosalpinx problem.It was divided into two subgroups according to ages of freeze, C1 group≤1 year, 136 circles concluded, C2>1 year with 84 circles.Patients in group D had their hydrosalpinx aspiration on FET day(n=44).Pregnancy outcormes were compared.Results The clinical pregnancy rate in group A(69.1%) was significantly higher than that in group B(54.9%)、group C(55.0%) and group D(54.5%)(P<0.05).The embryo implantation rate was the highest in group A(41.9%)compared with other groups(P<0.05).The number of eggs obtained in group A(9.4±6.1) was lower than that in other groups(P<0.05),and the multiple preganancy rate in group A(15.2%) was higher than that in group B(3.9%).There were no significant differences in fertilization rate, number of transferred embryos and ectopic pregnancy rate among groups(P>0.05).A low clinical prenancy rate(53.7%) and embryo implantation rate(31.2%) were found in group C1 were lower than those in group C2(57.1% and 35.7%),but the differences were not statistically significant(P>0.05),the multiple pregnancy rate in group C2 was higher than that in group C1(P<0.05).No other significant differences were found.Conclusion Hydrosalpinx has an adverse effect on the clinical outcome of IVF-ET.Aspiration on the day of fresh embryo t

关 键 词：输卵管积水 积水抽吸术 新鲜胚胎移植 冻融胚胎移植 

分 类 号：R711.6[医药卫生—妇产科学]