纵隔子宫IVF/ICSI-ET助孕前行宫腔镜下子宫纵隔切除手术对妊娠结局的影响

Effect of Hysteroscopic Uterine Mediastinal Resection on Pregnancy Outcome before IVF/ICSI-ET in Uterus Septus

目的探讨纵隔子宫不孕患者IVF/ICSI助孕前行宫腔镜下子宫纵隔切除术的妊娠结局。方法回顾性分析2009年1月～2017年12月于我中心接受IVF/ICSI-ET助孕的纵隔子宫患者62例的临床病历资料。根据患者是否行宫腔镜下子宫纵隔切除术(TCRS),分为手术组34例和未手术组28例。随机抽取同期子宫形态正常的不孕患者60例作为对照组。分析IVF/ICSI-ET助孕的妊娠结局。结果手术组的临床妊娠率(70.59%)高于未手术组(42.86%),差异有统计学意义(P<0.05);足月产率(53.85%)高于未手术组(25.00%),差异无统计学意义(P>0.05);早产率(23.07%)低于未手术组(56.25%),差异有统计学意义(P<0.05)。手术组与对照组比较,临床妊娠率(70.59%vs 63.33%)、临床妊娠率(40.63%vs 36.36%)、流产率(23.07%vs 18.18%)、早产率(23.07%vs 22.73%)、足月产率(53.85%vs 59.09%),差异无统计学意义(P>0.05)。结论纵隔子宫不孕患者行IVF/ICSI-ET助孕前,建议行宫腔镜下子宫纵隔切除手术,可改善妊娠结局。纵隔子宫不孕患者行宫腔镜下子宫纵隔切除手术后与正常宫腔形态不孕患者相比,IVF/ICSI-ET助孕的妊娠结局相似。

Objective To investigate the pregnancy outcome of hysteroscopic uterine mediastinal resection before IVF/ICSI assisted pregnancy in patients with uterus septus infertility.Methods The clinical records of 62 patients with uterus septus who received IVF/ ICSI-ET during pregnancy from January 2009 to December 2017 were retrospectively analyzed.According to whether the patient underwent hysteroscopic uterine mediastinal resection （TCRS）,34 patients in the surgical group and 28 patients in the unoperated group.60 infertile patients with normal uterine morphology were randomly selected as the control group.Analyze the pregnancy outcome of IVF/ICSI-ET.Results The clinical pregnancy rate （70.59%）in the surgical group was higher than that in the unoperated group（42.86%）,the difference was statistically significant （P〈0.05）;the full-term yield（53.85%）was higher than the unoperated group （25.00%）,the difference was not statistically significant （P〉0.05）;the preterm birth rate （23.07%）was lower than that in the unoperated group（56.25%）,the difference was statistically significant（P〈0.05）.Compared with the control group,the clinical pregnancy rate（70.59% vs 63.33%）,clinical pregnancy rate（40.63% vs 36.36%）,abortion rate（23.07% vs 18.18%）,preterm birth rate（ 23.07% vs 22.73%）,full- term yield （53.85% vs 59.09%）,the difference was not statistically significant （P〉0.05）.Conclusion In patients with uterus septus infertility before IVF/ICSI-ET assisted pregnancy, hysteroscopic uterine mediastinal resection is recommended to improve pregnancy outcome.In patients with uterus septus infertility,the pregnancy outcome of IVF/ICSI-ET was similar to that of normal uterine infertility after hysteroscopic uterine mediastinal resection.