GnRH-a联合IVF-ET治疗子宫腺肌病不孕患者的妊娠结局分析

Outcome analysis of adenomyosis patients achieved pregnancy through combined treatment of IVF-ET and GnRH-a

目的分析促性腺激素释放激素激动剂(GnRH-a)联合体外受精-胚胎移植(IVF-ET)治疗子宫腺肌病合并不孕患者的临床妊娠结局。方法回顾性分析156例不孕症患者,其中包括56例子宫腺肌病不孕和100例输卵管因素不孕的患者通过GnRH-a和IVF-ET治疗后分析两组的妊娠结局。结果病例组患者的获卵数(11.54±7.35 vs 15.56±7.25)、受精率(68.73%vs 81.43%)、卵裂率(93.24%vs97.79%)、胚胎种植率(41.79%vs 56.96%)、胎儿体重(kg)(2.81±0.80 vs 3.22±0.76)均明显低于对照组,差异有统计学意义(P<0.05)。病例组的自然流产率(25.00%vs10.00%)、早产率(28.57%vs 10.00%)、胎膜早破率(16.67%vs 3.33%)均明显高于对照组,差异有统计学意义(P<0.05)。而低出生体重儿率(28.57%vs 16.67%)、妊娠期高血压率(9.52%vs 7.78%)、妊娠期贫血率(7.14%vs5.56%)、前置胎盘率(4.76%vs 5.56%)之间两组差异无统计学意义(P>0.05)。结论子宫腺肌病患者的IVF-ET不良妊娠结局较输卵管不孕患者明显增多。

Objective To analyze the impact of adenomyosis on outcomes of women achieved pregnancy through combined treatment of GnRH-a and IVF -ET. Methods A retrospective study of 156 infertile women, including 56 patients with infertility due to adenomyosis and 100 patients with tubal factor infertility. All patients obtained pregnancy through IVF -ET. Results Oocytes-retrieved number （11. 54 ± 7. 35 vs 15.56 ± 7. 25）, fertilization rate （68. 73% vs 81. 43% ） , cleavage rate （93.24% vs 97. 79% ） ,implantation rate （41. 79% vs 56.96% ） and birth weight （2. 81 ± 0. 80 vs 3. 22 ± 0. 76） in the adenomyosis group decreased obviously, compared to the tubal factor group （P 〈0. 05）. Rates of spontaneous abortion （25.00% vs 10.00%）, preterm birth （28.57% vs 10.00%）, premature rupture of membranes （16.67% vs 3.33%） increased significantly in the adenomyosis group （P 〈 0.05）. Rates of small-for-gestational-age（SGA） infants （28.57% vs 16.67%）, pregnancy hypertension（9. 52% vs 7.78% ） , pregnancy anemia （7. 14% vs 5. 56% ） , placenta previa （4.76% vs 5. 56% ） between the two groups were not statistically significant （P 〉0. 05）. Conclusion The rates of adverse pregnancy outcome in adenomyosis patients increase significantly, compared to patients with tubal factor infertility.