体外受精-胚胎移植后发生异位妊娠34例临床分析

Clinical Analysis of 34 Cases of Ectopic Pregnancy after in vitro Fertilization and Embryo Transfer

目的:探讨体外受精-胚胎移植(IVF-ET)后异位妊娠的发生率、相关因素及诊疗方法。方法:回顾性分析IVF-ET后发生异位妊娠34例的临床资料。结果:1 140例临床妊娠中,宫内妊娠1 106例,异位妊娠34例(2.98%),包括宫内外同时妊娠5例。输卵管因素不孕异位妊娠的发生率为4.4%(27/619),远高于因子宫内膜异位症、排卵障碍等因素异位妊娠的发生率。年龄、受精方式、胚胎来源和移植次数对异位妊娠的发生率无明显影响。结论:IVF-ET后异位妊娠发生率较自然妊娠时高,而输卵管病变是影响IVF-ET后异位妊娠发生率的主要因素。妊娠早期通过血HCG和B超监测,有助于异位妊娠的早诊断和早治疗。

Objective: To study the incidence,risk factors and clinical manifestation for ectopic pregnancy after in vitro fertilization and embryo transfer( IVF-ET). Methods: Retrospective study of 34 cases of ectopic pregnancy after IVF-ET. Results: Of 1 140 clinical pregnancy,there were 1 106 intrauterine pregnancy and 34 ectopic pregnancy( 2. 98%),including 5 heterotopic pregnancy. The incidence of ectopic pregnancy in tubal factor group was 4. 4%( 27/619),higher than that of other factors. There was no correlation between age,fertilization way,source of embryo,transplantation times and ectopic pregnancy. Conclusion: Incidence of ectopic pregnancy after IVF-ET is higher than that of natural pregnancy,with tubal factors to be the closely related. Early measurement of blood HCG and B ultrasound contribute to the early diagnosis and treatment of ectopic pregnancy.