子宫内膜息肉对不孕患者临床妊娠的影响

Influence of Endometrial Polyps on Clinical Pregnancy of Infertile Patients

【目的】探讨子宫内膜息肉对不孕患者临床妊娠的影响。【方法】采用回顾性对照研究,收集2011年1月至2012年3月间因不孕在本院门诊行宫腔镜检查及治疗且成功随诊的400例患者的临床资料,按随诊时患者既往助孕情况分为助孕失败组与未助孕组,同时根据此次门诊宫腔镜检查结果将各组再分为息肉摘除亚组和正常宫腔亚组。分别比较两组内息肉摘除亚组和正常宫腔亚组的临床妊娠率。并根据年龄将不孕患者分为"≤35岁"与">35岁"两组,统计两个年龄段子宫内膜息肉发生率及子宫内膜息肉摘除后妊娠情况。【结果】助孕失败组内息肉摘除亚组患者临床妊娠率40.91%高于正常宫腔亚组23.21%,差异有统计学意义(P=0.024);未助孕组内息肉摘除亚组临床妊娠率47.83%高于正常宫腔亚组36.36%,差异无统计学意义(P=0.103)。助孕失败患者子宫内膜息肉发生率在不同年龄段两组间无统计学差异(P=0.123),而未助孕患者息肉发生率≤35岁组25.8%,大于>35岁组12%,差异有统计学意义(P=0.039);不论助孕失败组与未助孕组患者,息肉摘除后临床妊娠率在不同年龄段两组间均无统计学差异(P=0.127,P=0.667)。【结论】子宫内膜息肉是影响助孕过程中胚胎种植的一个独立因素,也可能是影响不孕的相关因素;各年龄助孕失败患者,未尝试助孕的≤35岁的不孕患者,应尽早行宫腔镜检查,帮助诊断、摘除子宫内膜息肉,有助于提高其临床妊娠。

[Objective] To investigate the influence of endometrial polyps on clinical pregnancy of infertile patients.[Methods] Clinical data of 400 successfully followed-up infertile patients in our hospital with outpatient hysteroscopy from January 2011 to March 2012 were collect using retrospective case-control study.According to previous assisted reproduction situation,the patients were divided into the ＂assisted reproduction failed group＂ and ＂none assisted reproduction group＂,and according to the outpatient hysteroscopy results,each group was further divided into ＂polypectomy subgroup＂ and ＂normal uterine cavity subgroup＂.And the infertile patients were divided into two groups of ＂≤ 35 year＂ and ＂〉 35 year＂ according to the age,incidence of endometrial polyps and pregnancy rate after endometrial polyps removed were investigated.[Results] The clinical pregnancy rate of ＂polypectomy subgroup＂ was 40.91%,which was higher than 23.21% of ＂normal uterine cavity subgroup＂ in ＂assisted reproduction failed group＂,the difference was statistically significant （P =0.024）.The clinical pregnancy rate of ＂polypectomy subgroup＂ was 47.83%,which was higher than that of ＂normal uterine cavity subgroup＂ in ＂none assisted reproduction group＂,the difference was not statistically significant （P =0.103）.There was no statistical difference between two age groups about the incidence of endometrial polyps in assisted reproduction failed patents（P =0.123）.And in none assisted reproduction group,the difference was statistically significant （P =0.039）,that in ＂≤ 35 year＂ was 25.8% and ＂〉 35 year＂ was 12%.Regardless of assisted reproduction failed or none assisted reproduction group,clinical pregnancy rate after polyp been removed in different age groups showed no statistical difference （P =0.127,P =0.667）.[Conclusion] Endometrial polyps is an independent factor affecting embryo implantation in assisted reproduction process,which may also be the factor related to infertility.Assisted reproductive failed patients of all age,especially those less than 35-years-old women without assisted reproduction.Early diagnosis and removal of endometrial polyps with hysteroscopy is useful to improve the clinical pregnancy.