首次体外受精-胚胎移植周期前宫腔镜检查对妊娠结局的影响

Effect of hysteroscopy before the first in vitro fertilization-embryo transfer on pregnancy outcome

目的 评估首次体外受精-胚胎移植周期前行宫腔镜检查对患者妊娠结局的影响. 方法 对2011-01-09 ～2013-01-07需行首次IVF治疗的1 548例患者临床资料进行回顾性分析,将患者分为三组,A组未行宫腔镜检查,B组行宫腔镜检查未发现宫腔病变,C组宫腔镜检查发现病变并行治疗,对比三组患者IVF妊娠结局的差异. 结果 A、B、C组患者的IVF周期参数之间无统计学差异,但IVF妊娠结局有显著差异,三组临床妊娠率分别为25.87％,29.90％,34.26％,活胎分娩率分别为20.50％,25.78％和34.26％,两组数据均以宫腔镜检查发现异常并行治疗组为最高. 结论 首次IVF开始前行宫腔镜检查的患者IVF妊娠结局显著优于未行检查者,故IVF治疗前建议常规行诊断性宫腔镜检查.

Objective To assess the effect of diagnostic hysteroscopy on pregnancy outcome in patients starting the first in vitro fertilization（IVF） cycle.Methods A total of 1 548 infertile women undergoing the first IVF treatment from January 2011 to January 2013 were reviewed retrospectively.All the patients were divided into three groups.The patients underwent IVF without hysteroscopy evaluation in group A,hysteroscopy and normal uterine cavity in group B,and diagnostic and therapeutic hysteroscopy in group C.The IVF outcomes among three groups were compared.Results There was no difference among three groups with regard to the clinical characteristics and cycle parameters.However,the IVF outcome was significantly different among three groups.The clinical pregnancy rate （CPR） in groups A,B and C was 25.87％,29.90％,34.26％,respectively.The live birth rate （LBR） was 20.50％,25.78％,34.26％ in groups A,B and C.CPR and LBR were the highest in group C （P ＜ 0.05）.Conclusion The patients who receive hysteroscopy prior to first IVF cycle have higher implantation rate and live birth rate than those who have not.The routinely performing diagnostic hysteroscopy before the first IVF program is recommended.