子宫颈分泌物UU、CT阳性对单精子注射-胚胎移植患者对妊娠结局及新生儿的影响

Study on the impact of cervical secretion with Ureaplasma urealyticum and Chlamydia trachomatis on the outcomes of pregnant women with sperm injection- embryo transplantation and neonates

目的探讨子宫颈分泌物解尿支原体(UU)、沙眼衣原体(CT)阳性对单精子注射-胚胎移植(IVF/ICSI-ET)患者对妊娠结局及新生儿的影响。方法收集2014年7月至2015年7月在生殖中心术前行UU及CT检查的1 280例首次行IVF/ICSI-ET治疗的患者临床资料,根据UU、CT检测结果分为UU阳性组(n=285)、CT阳性组(n=245)、UU+CT阳性组(n=148)及UU+CT阴性组(n=602),对上述各组随访至分娩,观察各组间妊娠结局及新生儿出生情况。结果 UU+CT阳性组、UU阳性组及CT阳性组输卵管炎、原发性不孕、继发性不孕高于UU+CT阴性组(P<0.05)。UU+CT阳性、UU阳性组及CT阳性组受精率、优质胚胎率、胚胎种植率、临床妊娠率显著高于UU+CT阴性组(P<0.05)。UU+CT阳性组围产儿感染、早产儿、胎儿宫内窘迫、围产儿病死率、羊水污染、新生儿窒息、新生儿肺炎、发生率高于其余3组(P<0.05)。结论 UU、CT感染可引起IVF/ICSI-ET患者不良妊娠结局,并影响胎儿出生质量。因此对于术前已经感染UU、CT患者建议治愈后才行胚胎移植,以提高IVF/ICSI-ET手术成功率。

Objective To explore the impact of cervical secretion with Ureaplasma urealyticum（ UU） and Chlamydia trachomatis（ CT）on the outcomes of pregnancy and neonates in sperm injection- embryo transplanted patients. Methods The clinical data of 1280 cases for first time with IVF / ICSI- ET treatment during July 2014 to July 2015 were divided into UU positive group（ n = 285）,CT positive group（ n = 245）,UU ＋ CT positive group（ n = 148） and UU ＋ CT negative group（ n = 602）. All patients were followed up until delivery,and the outcome of pregnancy and the situation of birth were observed between these groups. Results The incidence rates of salpingitis,primary infertility and secondary infertility were higher in patients of UU ＋ CT positive group,UU positive group and CT positive group than those of patients in UU ＋ CT negative group（ P〈0. 05）. The fertilization rate,high quality embryo rate,implantation rate and clinical pregnancy rates in patients of UU ＋ CT positive group,UU positive group and CT positive group were significantly higher than those of UU ＋ CT negative group（ P〈0. 05）. The incidence rates of perinatal infection,premature neonates,fetal distress,perinatal mortality,meconium,neonatal asphyxia and neonatal pneumonia in patients of UU ＋ CT positive group were higher than those of patients in other three groups（ P〈0. 05）. Conclusion Patients with UU and CT infection can cause IVF / ICSI- ET treatment with adverse outcome of pregnancy and affect the quality of birth,therefore patients already infected with UU and CT are recommended to cure these diseases before embryo transplantation in order to raise the successful rate of IVF / ICSI- ET surgery.