胚胎移植后输卵管妊娠的高危因素分析

Analyze the Ectopic Pregnancy after in Vitro Fertilization and Embryo Transfer

目的:探讨不孕症患者辅助生殖技术胚胎移植后输卵管妊娠高危因素及诊断。方法:对不孕症患者辅助生殖技术后输卵管妊娠者和同时期宫内单胎妊娠患者(对照组)的临床资料进行回顾性分析。结果:输卵管妊娠组既往存在输卵管病变者明显高于宫内单胎妊娠组(P<0.05);采用卵母细胞单精子注射(ICSI)发生输卵管妊娠多于体外受精(IVF)治疗者(P<0.05);冷冻胚胎移植输卵管妊娠发生率较采用新鲜胚胎移植者更高(P<0.05);宫内单胎组胚胎移植后14天血β-HCG浓度要明显高于输卵管妊娠组(P<0.01)。输卵管妊娠组β-HCG倍增时间明显长于宫内单胎组(P<0.01)。结论:不孕症患者辅助生殖技术(ART)胚胎移植后输卵管妊娠的发生率高与输卵管病变有关。胚胎移植后测定β-HCG,结合经阴道超声检查有助于输卵管妊娠的早期诊断。

Objective： To analyze risk factors of ectopic pregnancy （EP） after in vitro fertilization - embryo transfer （ IVF - ET）, and its diagnosis. Methods：Tha clinical data of EP group and control group （intrauterine singleton pregnancy） were retrospectively analyzed. Results：Tha EP group had higher fallopian tube diseases history than control group,76% and 43% respectively; EP patients treated by ICSI were more than those by IVF（ X^2 = 4.11, P〈 0.05） ; EP patients after frozen embryo transfer were more than those after fresh embryo transfer（ X^2 = 4： 57, P 〈 0.05） ; EP patients＇ average serurnβ-HCG level at Day 14 after ET was obviously lower than those from the normal pregnancy （P〈 0.01 ）, and the doubling time （3.6 vs 1.7 days） was significant longer （ P〈 0.01 ） .Conclusions：Tubal pathology is associated with increased risk of EP. β-HCG assay assisted with Transvaginal ultrasound inspection are helpful to the early diagnosis of EP.