经腹纵切面与改良法超声引导下胚胎移植异位妊娠发生率的比较

Comparison of ectopic pregnancy rate in embyo transfer using transabdominal longitudinal section scan or modified method of ultrasound-guidance

目的评价经腹纵切面与改良法超声引导下胚胎移植在辅助生育技术（assisted reproductive technology,ART）中异位妊娠（ectopic pregnancy,EP）的发生率。方法回顾性分析2014年1月-2015年9月我院生殖医学中心在两种方式超声引导下移植胚胎EP的发生率。传统法（A组）经腹超声纵切面扫描宫腔线,将胚胎种植在距宫底部内膜5～10 mm处;改良法（B组）经腹纵切面确定移植管位置后,再扫描子宫横切面调整移植管深度。结果 A组333周期数,平均年龄（33.81±4.77）岁;B组295周期数,平均年龄（34.29±4.71）岁;两组平均年龄等临床资料及临床妊娠率（clinical pregnancy,CP）均无统计学差异。B组EP发生率明显低于A组（0.3%vs 2.4%,P=0.030）。结论经腹纵切面结合横切面的改良法超声引导方式能降低ART中EP的发生率,是一种安全有效的胚胎移植技术。

Objective To evaluate the ectopic pregnancy（EP） rate of embryo transfer in assisted reproductive technologies（ART） using transabdominal longitudinal section scanning or modified method of ultrasound-guidance. Methods The EP rate of patients undergoing embryo transfer by two different methods of ultrasound-guidance from January 2014 to September 2015 in our ART center was retrospectively analyzed. The traditional method（group A） was simply scanned the endometrium lining longitudinally by putting the tip of the catheter 0.5-1 cm beyond fundus, and the modified method（group B） was to put the tip by longitudinal section at first, then adjust the catheter depth by transverse section scanning. Results There were 333 cycles in group A with average age of（33.81±4.77） years and 295 cycles in group B with average age of（34.29±4.71） years. There were no significant differences in mean age and clinical pregnancy（CP） rate between two groups. While, the EP rate in group B was significantly lower than group A（0.3% vs 2.4%, P=0.030）. Conclusion This study suggests that implanting the embryos under the guidance of modified method of longitudinal combined transverse section scanning can reduce the EP rate in ART, which is an effective and safe technique for embryo transfer.