输卵管积水抽吸术配合耳穴贴疗对体外受精-胚胎移植结局的影响

Effects of Tansvaginal Aspiration of Hydrosalpinx Combined Auricular Point Sticking on IVF-ET Outcomes

目的探讨冷冻胚胎移植前输卵管积水处理的有效方法。方法将229例冷冻胚胎移植并伴有输卵管积水的患者,采用随机数字表进行分组。研究组为输卵管积水抽吸术配合耳穴贴疗组(A组)94例,输卵管积水抽吸组(B组)89例,输卵管积水未处理组(C组)46例作为对照组。比较3组患者冻融胚胎移植周期结局及移植日子宫内膜和内膜下血流分布。结果 3组患者的冻胚移植日子宫内膜厚度、移植胚胎数和移植的优质胚胎数比较,差异均无统计学意义(P>0.05);A组的临床妊娠率及胚胎种植率均明显高于C组,且临床妊娠率亦高于B组,差异均有统计学意义(P<0.05)。早期流产率与移植取消率A组明显低于C组,差异亦有统计学意义(P<0.05)。A组的子宫内膜和内膜下血流分布以A型分布为主,A型分布率均明显高于B组和C组;B组的A型分布率也高于C组,差异均有统计学意义(P<0.05)。结论输卵管积水抽吸配合耳穴贴疗方案处理输卵管积水能提高子宫内膜容受性,改善体外受精-胚胎移植的结局。

Objective To explore effective pretreated methods for hydrosalpinx before frozen embryo transfer（TET）.Methods A randomized controlled study was performed on 229 FET cycles of hydrosalpinx patients.They were assigned to two groups by random digit table,Group A（94 cases）,Group B（89 cases）,and Group C（46 cases）.Patients in Group A received transvaginal aspiration of hydrosalpinx combined with auricular point sticking.Those in Group B received transvaginal aspiration of hydrosalpinx group.Those in Group C received no transvaginal aspiration of hydrosalpinx.Pregnancy outcomes of FET,endometrial and subendometrial blood flow distribution on the embryo transfer day were compared among the three groups.Results There was no statistical difference in the endometrial thickness on FET day,the number of transfer embryos,the number of transferred good quality embryos among the three groups（P 〉0.05）.The clinical pregnancy rate and the embryo implantation rate were significantly higher in Group A than in Group C（P 〈0.05）,and the clinical pregnancy rate was significantly higher in Group A than in Group B（P 〈0.05）.The early abortion rate and the transfer cycle cancel rate were significantly lower in Group A than in Group C（P 〈0.05）.Type A endometrial and subendometrial blood flow distribution was dominant in Group A,which was significantly higher in Group A than the rest two groups（P 〈0.05）.Type A distribution rate was also significantly higher in Group B than in Group C（P〈0.05）.Conclusion Transvaginal aspiration of hydrosalpinx combined with auricular point sticking before FET could improve the endometrial receptivity and improve outcomes of IVF.