干预治疗对子宫内膜形态不良者体外受精-胚胎移植结局的影响

Effect of Intervention Treatment on Outcomes of in Vitro Fertilization-Embryo Transfer in Patients with Endometrial Abnormalities

目的：探讨干预治疗对超声检查显示子宫内膜形态不良的不孕患者体外受精-胚胎移植（IVF-ET）结局的影响。方法：采用回顾性对照研究,选择近排卵期子宫内膜超声检查形态不良者并行子宫内膜搔刮的干预性治疗后至内膜回声正常的患者30例（34周期）为干预组,子宫内膜回声不良而未行干预性治疗的患者37例（40周期）为未干预组;另选择同期子宫内膜形态正常的不孕患者51例（53周期）为对照组。比较3组患者的临床特征、内膜厚度、卵巢反应和妊娠结局。结果：干预组30例患者中,19例干预治疗1次,2例干预治疗4次,其余9例干预治疗2-3次后至内膜形态基本恢复正常。3组患者的基本临床特征、内膜厚度、卵巢反应、受精数以及移植胚胎数等比较,差异均无统计学意义（P〉0.05）。干预组的胚胎种植率、周期临床妊娠率（27.1%,50.0%）均高于未干预组（13.4%,25.0%）,差异有统计学意义（P〈0.05）,但与对照组（19.4%,35.8%）相比,差异无统计学意义（P〉0.05）。未干预组的胚胎种植率、周期临床妊娠率低于对照组,但差异无统计学意义（P〉0.05）。结论：超声检查提示子宫内膜形态不良的患者行干预治疗至内膜回声正常后有利于提高子宫内膜容受性,改善IVF-ET治疗结局。

Objective： To investigate the effect of intervention treatment on in vitro fertilization-embryo transfer（IVF-ET） outcomes in patients with endometrial abnormalities. Methods： By retrospective controlled study, 127 patients were divided into three groups as follows.intervention treatment group ：30 patients（34 cycles）with endometrial abnormalities in ultrasound treated with intervention treatment until the ultrasound outcome was normal; non-intervention treatment group.37 patients（40 cycles）with endometrial abnormalities in ultrasound but without treatment; control group：51 patients （53 cycles）with normal endometrium in ultrasound. The clinical features, endometrial thickness, ovarian response and pregnancy outcomes were compared among groups,and the clinical outcomes of therapeutic intervention on IVF were analyzed. Results： The clinical pregnancy rate in intervention treatment group was higher than non-intervention group （P 〈 0. 05 ）. There was no difference between intervention treatment group and control group （ P 〉 0. 05）. The clinical pregnancy rate in non-intervention group was lower than control group, but there was no significance（ P 〉 0. 05）. Conclusions： Intervention treatment to the endometrial abnormalities can improve endometrial receptivity and ameliorate IVF-ET outcome.