体外受精-胚胎移植失败202例宫腔镜检结果分析

Analysis of uterine cavity of patients underwent failed attempts of in vitro fertilization-embryo transfer by hysteroscopy

目的评价体外受精(IVF)-胚胎移植(ET)失败患者的宫腔情况,探讨宫腔镜对分析IVF-ET失败的应用价值。方法对202例接受常规体外受精或卵胞浆内单精子注射(ICSI)-ET失败患者再次助孕前行宫腔镜检查,对异常宫腔患者进行相应治疗后再次助孕。结果正常宫腔115例(56.9%),异常宫腔87例(43.1%)。异常宫腔中以子宫内膜息肉、子宫内膜薄、子宫内膜炎多见,共占76.9%。年龄≥35岁与子宫内膜厚度<8mm者异常宫腔发生率高(P<0.05)。异常宫腔患者经相应治疗后再次助孕临床妊娠率与正常宫腔者相似(P>0.05)。结论IVF/ICSI失败患者宫腔异常发生率较高,特别是≥35岁者。IVF/ICSI失败后宫腔镜检查对提高再次助孕妊娠率具有重要意义。

Aim ： To evaluate uterine cavity of the patients who underwent one or more failed attempts of in vitro fertilization-embryo transfer（ IVF-ET ） and determine the value of hysteroscopy prior to another cycle of assisted conception. Methods： A total of 202 patients who had undergone one or more failed attempts of IVF/ICSI underwent hysteroscopy, and appropriate medical or surgical treatment was given to the patients with uterine abnormalities before entering another cycle of assisted eenception. Results： Of 202 patients, 115 patients （56.9%） had normal cavities and 87 patients （43.1%） had abnormal findings really including endometrial polyps, thin endometrium, and endometritis which accounted for 76.9%. The incidence of intrauterine pathology was significantly higher in the patients more than 35 years old and with endometriual thickness less than 8 mm by intravaginal ultrasound （ P 〈 0. 05 ）. In the patients who had been treated appropriately, clinical pregnancy rate was similar to those patients with normal cavity （ P 〉0. 05 ）. Conclusion： Uterine cavity assessment should be routinely performed in patients undergoing failed attempts of IVF, which is helpful in increasing pregnancy rate in next IVF treatment.