416例不孕症患者宫腔镜检查临床分析

Analysis of 416 cases of diagnostic hysteroscopy of infertility

目的探讨不孕症患者,尤其有体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)失败病史的患者常规宫腔镜检查的必要性。方法应用宫腔镜对416例不孕症患者(其中原发不孕154例,继发不孕262例)进行常规检查,观察不孕症患者的宫腔情况。结果 416例患者中,发现存在宫腔病变211例(占50.7%)。原发性不孕组的子宫粘膜下肌瘤和宫腔粘连的发生率分别为1.3%和6.5%,继发性不孕组的发生率分别为2.3%和27.5%,两组相比,差异有显著意义(P<0.01)。有IVF-ET失败病史的不孕症患者64例,有宫腔病变41例(占64.0%),与总病例的宫腔病变率相比,差异有显著意义(P<0.01)。结论在不孕症患者中,继发性不孕患者和有IVF-ET失败病史患者的宫腔病变发生率较高。因此,对于不孕症患者,尤其是继发性不孕和有IVF-ET失败病史的患者常规行宫腔镜检查是有价值的。

Objective To investigate the necessity of hysteroscopy for infertile women,especially underwent failure of in vitro fertilization and embryo transfer（IVF-ET）.Method 416 infertile women who had the hysteroscopy were analyzed,and investigated the uterine case of the infertile patients.Result Of the 416 patients,211 patients had uterine diseases（50.7%）.In primary infertility group,the incidence rate of uterine submucous myoma,intrauterine adhesion were 1.3% and 6.5%,respectively,and in secondary infertility groups were 2.3% and 27.5%.64 patients underwent failture of in vitro fertilization-embryo transfer.23 ones had normal uterine（36.0%）,the rest all had uterine diseases（64.0%）.There was the statistical significance comparing with the incidence rate of uterine diseases of all the 416 patients（P〈0.01）.Conclusion There is a high incidence of uterine diseases on infertile women especially the secondary infertile ones,and which even higher on women underwent once or more failure of in vitro fertilization and embryo transfer.