胚胎移植周期中子宫内膜搔刮术的应用价值

Application of endometrial scraping in embryo transfer cycle

目的探讨子宫内膜搔刮术对胚胎移植周期中临床妊娠率的影响。方法回顾性分析行体外受精助孕胚胎移植1 879例患者,促排卵前均行超声检查。根据子宫内膜回声及子宫内膜厚度分为子宫内膜正常组及子宫内膜异常组两组。对子宫内膜异常者行子宫搔刮术,比较子宫内膜正常组与异常组及子宫内膜搔刮组与未搔刮组两组患者的临床妊娠率。结果子宫内膜正常组患者的年龄明显较子宫内膜异常组轻(30.56与32.77,P<0.01),临床妊娠率也较异常组明显增高(49.26%与41.87%,P<0.05)。对子宫内膜异常者行搔刮术后,搔刮组与未搔刮组两组之间年龄仍有显著性差异(33.11与31.41,P<0.01),但妊娠率无明显差异(53.72%与50.06%,P>0.05)。结论 (1)随着女性年龄的增大,子宫内膜回声异常机会增多;(2)子宫内膜异常者行搔刮术后可提高胚胎移植周期的临床妊娠率。

Objective To analyze the effect of endometrial scraping in embryo transfer cycle on clinical pregnancy rate. Methods The data of 1879 patients in embryo transfer cycles underwent in vitro fertlization-embryo transfer（IVF-ET） were retrospective analyzed.All patients underwent ultrasound examination before ovulation induction.They were divided into normal endometrium group and abnormal endometrium group according to endometrium echo and thickness.Patients with abnormal endometrium underwent endometrial scraping.Clinical pregnancy rates were compared between normal endometrium group and abnormal endometrium group,between underwent endometrial scraping group and control group. Results Female age was significant younger in normal endometrium group than that in abnormal endometrium group（30.56 and 32.77,P0.005）.The clinical pregnancy rate in normal endometrium group was 49.26% and that in abnormal endometrium group was 41.87%,which was statistically significant（P0.05）.In patients with abnormal endometrium who underwent endometrial scraping,female age was also significantly higher in abnormal endometrium group（33.11 and 31.41,P0.005）,and the clinical pregnancy rate has no significant difference in two group（53.72% and 50.06%,P0.05）. Conclusion（1）.Endometrial abnormal echo rate increases along with female age rising.（2）.Endometrial scraping in embryo transfer cycle can improve the clinical pregnancy rate.