反复种植失败患者T型宫腔成形术后体外受精临床结局分析

Analysis of the clinical reproductive outcome of repeated implantation failure after hysteroscopic metroplasty in women with a T shaped uterus

目的探讨反复种植失败T型宫腔患者在宫腔镜下行T型宫腔成形术前后体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)临床结局的差异。方法回顾性分析18例2016年3月—2018年5月期间在上海集爱遗传与不育诊疗中心,因IVF反复种植失败(移植失败≥3次)行宫腔镜检查术中诊断为T型宫腔的患者资料。所有患者行冷刀T型宫腔成形术,评估术后IVF-ET临床结局。结果18例反复种植失败的患者行宫腔镜T型宫腔成形术,术后第一次移植14例患者成功妊娠,其中单胎足月分娩8例,1例双胎早产胎儿存活。结论宫腔镜下宫腔成形术是诊断和治疗T型宫腔的一种有效手段,降低了不良妊娠结局的发生,改善部分IVF反复种植失败患者的临床妊娠结局。

Objective To investigate the outcome of repeated in vitro fertilization and embryo transfer (IVF-ET) failure patients with a T shaped uterus before and after hysteroscopic metroplasty. Methods A retrospective analysis of 18 cases of repeated IVF failure (3 or more failures) in our center was performed. The T shaped uterus was diagnosed and performed metroplasty with cold knife under hysteroscopy. The clinical outcome of IVF-ET was performed to evaluate the effect of the operation. Results Fourteen patients were transplanted successfully after the hysteroscopic operation, eight full-term single birth and one premature twin birhts were dilivered. Conclusion Hysteroscopic T shaped uterus metroplasty is an effective method for diagnosis and treatment of T shaped uterus, which reduces the incidence of poor pregnancy and improves the clinical reproductive outcome of partial IVF repeated failure patients.