超声引导下行胚胎移植对妊娠结局的影响

The Influences of ultrasound-guided embryo transplantation to pregnancy

目的研究超声引导下行胚胎移植对体外受精-胚胎移植结局的影响。方法回顾性分析2008年6月至2010年1月,接受体外受精-胚胎移植(包括卵母细胞内单精子注射)治疗的436个移植周期的资料,按照胚胎移植时有无B超引导分为常规胚胎移植组(常规组)和超声引导下胚胎移植组(超声组),分别有110个周期和326个周期,比较两组患者的临床妊娠率、胚胎种植率、胚胎残留率、异位妊娠率,困难移植率及内外移植管血染率。结果常规组和超声引导组的周期临床妊娠率分别是36.4%(40/110)和40.5%(132/326),P<0.05;胎种植率分别是16.4%(47/286)和23.5%(207/880),P<0.05;困难移植率分别是7.3%(8/110)和2.1%(7/326),P<0.05;内外移植管出血率7.3%(8/110)和4.6%(5/326),P<0.05;胚胎残留率分别是3.6%(4/110)和2.6%(8/326),P>0.05;异位妊娠率分别是2.2%(2/110)和1.5%(5/326),P>0.05。结论超声引导下行胚胎移植能提高体外受精-胚胎移植的胚胎种植率,降低困难移植率及内外移植管血染率,能有助于改善临床妊娠率,是一种有效的胚胎移植方法。

Objective To investigate the influences of the ultrasound-guided embryo transplantation to in vitro fertilization embryo transplantation.Method The data of patients received the in vitro fertilization embryo transplantation were analyzed.The patients were divided into two groups according to with or without B-ultrasound guidance on embryo transplantation.The two groups included normal embryo transplantation group（normal group） and the ultrasound-guided embryo transplantation group（ultrasound-guided group）.The clinical pregnancy rate,embryo implantation rate,embryo residual rate,ectopic pregnancy rate,difficult transplant rate and bleeding rate of inside and outside catheters were observed.Results Periodic clinical pregnancy rates of the normal group and the ultrasound-guided group were 36.4%（40/110） and 40.5%（132/326）,P0.05.The embryo implantation rates were 16.4%（47/286） and 23.5%（207/880）,P0.05.The difficult transplant rates were 7.3%（8/110） and 2.1%（7/326）,P0.05.The bleeding rates of inside and outside catheters were 7.3%（8/110） and 4.6 percent（5/326）,P0.05.The embryo residual rates were 3.6%（4/110） and 2.6 percent（8/326）,P0.05.The ectopic pregnancy rates are 2.2 %（2/110） and 1.5%（5/326）,P0.05.Conclusion Ultrasound-guided embryo transplantation can increase the embryo implantation rate of in vitro fertilization embryo transplantation,reduce the difficult transplant rate and internal and bleeding rate of inside and outside catheters,and will be helpful to improve the clinical pregnancy rate,is an effective method of embryo transplantation.