宫腔镜检查在体外受精-胚胎移植中的应用价值

Application value of hysteroscopy in in vitro fertilization-embryo transfer

目的:探讨宫腔镜检查在体外受精-胚胎移植(IVF-ET)中的应用价值。方法:对223例进行IVF-ET治疗失败后的不孕妇女进行宫腔镜检查,以排除是否存在宫腔病变;其中198例进行了内膜活检,对所获资料进行分析。结果:223例患者中,宫腔镜检查结果异常67例(30.05%),其中子宫内膜息肉13例、子宫内膜炎11例、宫腔粘连10例、子宫内膜肥厚8例、子宫内膜肥厚伴息肉7例、子宫内膜薄5例、不完全子宫纵隔3例、大型宫腔(未排壁间肌瘤及子宫腺肌症)3例、黏膜下肌瘤2例、宫腔粘连伴内膜息肉1例、不完全子宫纵隔伴子宫内膜息肉1例、大型宫腔伴子宫内膜肥厚1例、大型宫腔伴黏膜下肌瘤1例、大型宫腔及子宫内膜薄伴子宫内膜炎1例。198例子宫内膜病理活检结果显示,正常子宫内膜174例(87.9%),其中增生期114例,分泌期60例;异常子宫内膜24例(12.1%)。结论:宫腔镜检查应作为不孕症患者IVF-ET助孕治疗前的常规检查。

Objective：To explore the application value of hysteroscopy in in vitro fertilization-embryo transfer（IVF-ET）.Methods：223 infertile women failing in IVF-ET received hysteroscopy in order to exclude uterine lesions;198 women underwent biopsy of endometrium,then the data were analyzed.Results：Among 223 cases,67 cases（30.05%） were found with abnormal hysteroscopic results,including 13 cases with endometrial polyps,11 cases with endometritis,10 cases with intrauterine adhesion,8 cases with hypertrophy of endometrium,7 cases with hypertrophy of endometrium combined with endometrial polyps,5 cases with thin endometrium,3 cases with incomplete uterine septum,3 cases with large uterine cavity（including intramural myoma and adenomyosis）,2 cases with submucosal myoma,1 case with intrauterine adhesion combined with endometrial polyps,1 case with incomplete uterine septum combined with endometrial polyps,1 case with large uterine cavity combined with hypertrophy of endometrium,1 case with large uterine cavity combined with submucosal myoma,1 case with large uterine cavity combined with thin endometrium and endometritis.The results of pathological biopsy of endometrium in 198 cases showed that 174 cases（87.9%） were found with normal endometrium,including 114 cases at proliferative phase and 60 cases at secretory phase;24 cases（12.1%） were found with abnormal endometrium.Conclusion：Hysteroscopy should be used as a routine examination for infertile patients before IVF-ET.