子宫内膜搔刮术对多囊卵巢综合征患者妊娠结局的影响  

The effect of endometrial scratching on pregnancy outcomes in polycystic ovarian syndrome women

作　　者：赵金燕[1] 李向红[1] 陈庆[1] 王颖[1] ZHAO Jinyan;LI Xianghong;CHEN Qing;WANG Ying(Department of Gynecology and Obstetrics,The Second Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710004,China)

机构地区：[1]西安交通大学第二附属医院妇产科,陕西西安710004

出　　处：《西部医学》2023年第9期1345-1348,共4页Medical Journal of West China

基　　金：陕西省自然科学基础研究计划(20022JM-484)。

摘　　要：目的分析子宫内膜搔刮术对多囊卵巢综合征(PCOS)患者妊娠结局的影响。方法本研究回顾性分析了2016年10月—2018年12月于本院就诊的150例符合纳入标准的PCOS患者,其中75例PCOS患者为搔刮组,在排卵诱导周期的2~12天内进行了子宫内膜搔刮术。75例为对照组,未实施手术。结果两组之间的临床特征无统计学差异(P<0.05)。搔刮组和对照组的活产率分别为34.7%(26例)和25.3%(19例)。搔刮组的活产率有所提高,但两组之间无统计学差异(P=0.151)。两组间生化妊娠率、异位妊娠率、正在妊娠率、流产率无统计学差异。logistic回归分析显示,精子活力是搔刮组妊娠结局的独立影响因素(P=0.021)。结论尚无充分证据证明PCOS患者行子宫内膜搔刮术可改善其妊娠结局。故需要进一步设计良好的随机、对照、前瞻性大样本研究来证实或反驳子宫内膜搔刮术在改善PCOS患者妊娠结局中的作用。Objective To analyze the effect of endometrial scratching in infertile polycystic ovarian syndrome(PCOS)women.Methods This was a retrospective matched case-control study.Overall 150 eligible participants were included in our department from October 2016 to December 2018.Endometrial scratching was undertaken between days 2-12 of the ovulation induction cycle in 75 women with PCOS.Patients(n=75)in the control group did not undergo surgery.Results Clinical characteristics of the participants were comparable.The live birth rate per patient was found to be 26(34.7%)and 19(25.3%)in the intervention and control groups,respectively.Although the live birth rate was increased in the intervention group,no statistically significant difference was found between the two groups(P=0.151).There was no statistically significant difference in biochemical pregnancy rates,ectopic pregnancy rates,ongoing pregnancy rates,and miscarriage rates between the two groups.The bivariate and binary logistic regression analysis revealed that semen motility(which had been matched in the beginning)was the independent parameter related to the pregnancy outcomes in the intervention group(P=0.021).Conclusion Evidence is insufficient to determine whether there is a difference in pregnancy outcomes between endometrial injury and no intervention group in infertile PCOS women who attempting to conceive via sexual intercourse through ovulation induction.Further well-designed randomized,controlled,prospective large-sample patient studies are required to confirm or refute the role of endometrial scratching in improving pregnancy outcomes.

关 键 词：子宫内膜容受性 子宫内膜搔刮术 不孕症 PCOS 妊娠结局 

分 类 号：R711.75[医药卫生—妇产科学]