反复种植失败患者冻融胚胎移植前行宫腔镜诊治的效果  

Effect of Hysteroscopy Diagnosis and Treatment Before Frozen-Thawed Embryo Transfer in Patients with Repeated Implantation Failure

作　　者：习艳霞[1] 王慧春[1] 刘慧文[1] Xi Yanxia;Wang Huichun;Liu Huiwen(Reproductive Center of Beijing Haidian District Maternal and Child Health Care Hospital,Beijing 100080,China)

机构地区：[1]北京市海淀区妇幼保健院生殖中心,北京100080

出　　处：《中国社区医师》2023年第14期79-81,共3页Chinese Community Doctors

摘　　要：目的:探讨反复种植失败(RIF)患者冻融胚胎移植(FET)前进行宫腔镜检查和治疗的临床效果。方法:选取2016年1月—2020年5月于北京市海淀区妇幼保健院生殖中心进行FET的280例RIF患者作为研究对象,根据患者是否在FET前进行宫腔镜检查分为宫腔镜检查组和未行宫腔镜检查组;将宫腔镜检查组患者根据宫腔镜检查中是否发现病变分为宫腔镜检查未发现病变组及宫腔镜检查发现病变组。比较三组一般资料、FET妊娠结局。结果:三组患者的年龄、不孕时间、不孕类型、不孕原因和既往移植失败周期数比较,差异无统计学意义(P>0.05)。三组冻融移植方案选择情况、FET日内膜厚度、移植胚胎数、继续妊娠率比较,差异无统计学意义(P>0.05);宫腔镜检查未发现病变组、宫腔镜检查发现病变组临床妊娠率、胚胎种植率均高于未行宫腔镜检查组,差异有统计学意义(P<0.05)。结论:宫腔镜检查不仅可以评估RIF患者的宫腔情况,还可在检查的同时进行相应的治疗,改善子宫内膜容受性,提高妊娠率。对于未能找到明确原因的RIF患者,可考虑行宫腔镜检查后再进行FET。Objective:To explore the clinical effect of hysteroscopic examination and treatment before frozen-thawed embryo transfer(FET)in patients with repeated implantation failure(RIF).Methods:A total of 280 patients with RIF who received FET in Reproductive Center of Beijing Haidian District Maternal and Child Health Care Hospital between January 2016 and May 2020 were selected as the study subjects.According to whether the patients had undergone hysteroscopy before FET,the patients were divided into hysteroscopy group and non-hysteroscopy group.According to whether the lesion was detected by hysteroscopy,patients in the hysteroscopy group were divided into no lesion by hysteroscopy group and lesion by hysteroscopy group.The general data and FET pregnancy outcomes were compared in the three groups.Results:There was no significant difference in the age of patients,duration of infertility,type of infertility,cause of infertility,and number of previous implantatio failure cycles among the three groups(P>0.05).There was no significant difference in the selection of frozen-thawed transplant protocol,the endometrial thickness on the FET day,the number of transplanted embryos,and the continued pregnancy rate among the three groups(P>0.05).The clinical pregnancy rate and embryo implantation rate in the no lesion by hysteroscopy group and lesion by hysteroscopy group were higher than those in the non-hysteroscopy group,and the difference was statistically significant(P<0.05).Conclusion:Hysteroscopy can not only evaluate the uterine cavity of RIF patients,but also provide corresponding treatment along with the examination to improve endometrial receptivity and increase the pregnancy rate.For patients with RIF without a definite cause,hysteroscopy may be considered prior to FET.

关 键 词：反复种植失败 宫腔镜检查 冻融胚胎移植 

分 类 号：R714.8[医药卫生—妇产科学]