微创医学

目的探讨在体外受精-胚胎移植(IVF-ET)前行宫腔镜检查的应用价值。方法对准备行体外受精-胚胎移植的160例患者进行随机分组,其中80例作为研究组,在体外受精-胚胎移植前进行了宫腔镜检查并做相应治疗,随后进入IVF-ET周期;另外80例患者未行宫腔镜检查而直接行IVF-ET,作为对照组。对研究组的宫腔镜检查结果及两组的妊娠结局进行分析。结果研究组经宫腔镜检查,异常宫腔占61.25%;研究组与对照组的新鲜周期移植种植率分别为27.96%、15.06%,临床妊娠率分别为42.55%、22.86%;研究组与对照组的冻融胚胎移植种植率分别为27.69%、13.79%,临床妊娠率分别为42.42%、20.00%,研究组新鲜周期移植及冻融胚胎移植胚胎着床率与临床妊娠率均明显高于B组。结论体外受精-胚胎移植前行宫腔镜检查有重要的临床诊疗价值,对于女方输卵管因素性不孕、原发性不孕同时不孕年限>5年以上,或继发性不孕同时不孕年限>3年以上准备行体外受精-胚胎移植的患者,术前常规做宫腔镜检查可以提高临床妊娠率。

Objective To explore the application value of hysteroscopy before in vitro fertilization and embryo transfer ( IVF-ET) ． Methods 160 patients ready to receive IVF-ET were divided randomly into experimental group( n = 80) ，which were underwent hysteroscopy and responding treatment before IVF-ET，and control group ( n = 80 ) ，which were skipped hysteroscopy and entered IVF-ET treatment cycle directly． Hysteroscopy results of hysteroscopy of experimental group and pregnancy outcomes of the two groups were analyzed． Results Experimental group was found with an abnormal uterus cavity rate of 61． 25% by hysteroscopy． Fresh cycle implantation rates of the experimental group and the control group were 27． 96% and 15． 06%，respectively，and clinical pregnancy rates were 42． 55% and 22． 86%，respectively; Meanwhile， frozen-thawed embryo graft implantation rate of experimental group and the control group were 27． 69%，and 13． 79%，and the clinical pregnancy rates were 42． 42% and 20． 00%，respectively． Transplanted embryo implantation rate and clinical pregnancy rates of both fresh and frozen-thawed embryo transfer cycles of experimental group were significantly higher than those of control group． Conclusion Hysteroscopy before IVF-ET has important clinical value． It is indicated that routine hysteroscopy before IVF-ET can improve clinical pregnancy rate for woman with tubal factor infertility，primary infertility for more than 5 years or a secondary infertility for more than 3 years．