体外受精-胚胎移植后异位妊娠的危险因素、诊断及治疗

Risk factors of ectopic pregnancy after in vitro fertilization and embryo transfer

目的 探讨体外受精 -胚胎移植 (IVF-ET)后异位妊娠 (EP)的危险因素、诊断及治疗方法。方法 对我院 1992年 10月～ 2 0 0 2年 6月接受体外受精-胚胎移植治疗 (包括单精子胞浆内注射 ,ICSI)后 82 1例临床妊娠中 38例异位妊娠进行回顾性分析。结果 IVF -ET后异位妊娠的发生率 4 6 % ,多胚胎不同部位妊娠(HP)的发生率 0 6 %。异位妊娠组取卵数明显多于对照组。单因素分析发现异位妊娠史、盆腔炎性疾病 (PID)史是IVF-ET后异位妊娠的危险因素。结论 盆腔炎性疾病史、异位妊娠史是IVF -ET后异位妊娠的高危因素。胚胎移植后妇女激素水平可能与异位妊娠的发生相关 ,但需进一步的研究证实。早期诊断和微创性治疗 。

Objective Identification of risk factors of ectopic pregnancy (EP) after in vitro fertilization and embryo transfer (IVF-ET). Methods Over a period of nine years and eight months (Oct.1992 to Jun.2002), a total of 821 cases of success-clinical pregnancies were achieved after performing IVF or intracytoplasmic sperm injection (ICSI). Among them, 38 ectopic pregnancies were collected for a retrospective study to investigate the possible causative factors for EP. Results The respective morbidities of EP and heterotopic pregnancy (HP) were 4 6% and 0 6% respechtively after IVF-ET.The number of oocytes retrieved of EP group was significantly higher than that of control group.History of pelvic inflammatory disease (PID) and previous history of EP showed a positive correlation with EP. Conclusions History of PID and/or history of EP were the most prominent risk factors for EP after IVF-ET.The hormonal level of women after embryo transfer appeared to be the other risk factor which needs to be confirmed by further study.Early diagnosis and microsurgery may decrease the complication and mortality.