短期放置含铜宫内节育器对反复种植失败患者助孕活产率的影响  

Effect of short-term insertion of Cu-IUD on live birth rate in patients with repeated implant failure

作　　者：黄富英 陈静 韦红兰 李忻琳 马文红 Huang Fuying;Chen Jing;Wei Honglan;Li Xinlin;Ma Wenhong(Department of Gynecology,Nanning Maternal and Child Health Care Hospital,Nanning Guangxi 530028;Reproductive Center,Liuzhou Maternal and Child Health Care Hospital,Liuzhou Guangxi 545000;Reproductive Center,Nanning Maternal and Child Health Care Hospital,Nanning Guangxi 530000,P.R.China)

机构地区：[1]南宁市妇幼保健院妇科,广西南宁530028 [2]柳州市妇幼保健院生殖中心,广西柳州545000 [3]南宁市妇幼保健院生殖中心,广西南宁530000

出　　处：《中国计划生育和妇产科》2023年第8期96-100,共5页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的探讨宫腔镜下短期放置含铜宫内节育器(copper-containing intrauterine device,Cu-IUD)对宫腔形态正常的反复种植失败(recurrent implantation failure,RIF)患者助孕活产率的影响。方法前瞻性纳入2019年4月至2021年6月在南宁市妇幼保健院与柳州市妇幼保健院生殖中心接受辅助生殖治疗的RIF患者128例,行宫腔镜检查并提示宫腔正常后,根据随机数字表法将患者分为试验组(58例)和对照组(70例),试验组在宫腔镜检查后立即宫内放置Cu-IUD,2个月后取出;对照组无特殊处理;比较两组胚胎移植术后的流产率及活产率。结果两组流产率(32.14%vs 10.00%)差异有统计学意义(P<0.05),两组活产率(32.76%vs 38.57%)比较,差异无统计学意义(P>0.05)。根据胚胎移植与IUD取出间隔时间,将试验组分为≤2月与>2月两个亚组,≤2月组较>2月组流产率有增加的趋势(46.15%vs 20.00%),活产率呈下降趋势(23.33%vs 42.86%),但差异无统计学意义(P>0.05)。结论宫腔镜检查时放置Cu-IUD持续2个月经周期对宫腔形态正常RIF患者助孕活产率没有影响,可能增加流产率。Objective To investigate the effect of short-term placement of a copper-containing intrauterine device(Cu-IUD)under hysteroscopy on the live birth rate in patients with recurrent implant failure(RIF)with normal uterine cavity morphology.Methods A prospective inclusion of 128 RIF patients who received assisted reproduction therapy in Reproductive Center of Nanning Maternal and Child Health Care Hospital and Liuzhou Maternal and Child Health Care Hospital from April 2019 to June 2021,After undergoing hysteroscopy and indicating normal uterine cavity,the patients were divided into experimental group(58 cases)and control group(70 cases)according to the random number table method,and the experimental group placed Cu-IUD in utero immediately after hysteroscopy and removed it 2 months later.No special treatment in the control group.The miscarriage rate and live birth rate after embryo transfer in two groups were compared.Results There was significant difference in miscarriage rate(32.14%vs 10.00%)(P<0.05),and no significant difference in live birth rate(32.76%vs 38.57%)between two groups(P>0.05).According to the interval between embryo transfer and IUD removal,the experimental group was divided into two subgroups,≤2 months and>2 months,the miscarriage rate in≤2 months group increased compared with the>2 months group(46.15%vs 20.00%),and the live birth rate showed a decreasing trend(23.33%vs 42.86%),but the difference was not statistically significant(P>0.05).Conclusion Placement of a Cu-IUD during hysteroscopy for 2 menstrual cycles had no effect on the live birth rate in patients with normal uterine morphology and RIF and may increase miscarriage rates.

关 键 词：宫内节育器 宫腔镜检查 反复种植失败 

分 类 号：R714[医药卫生—妇产科学]