冻融胚胎移植日抽吸输卵管积水对妊娠结局的影响

Effect of hydrosalpinx aspiration on day of frozen-thawed embryo transfer on pregnancy outcome

目的探讨在冻融胚胎移植(FET)当天抽吸输卵管积水后移植囊胚对妊娠结局的影响。方法回顾性分析2015年1月至2018年6月期间在我院收治的符合条件的73例行IVF-ET助孕合并移植前经阴道B超下可视输卵管积水患者资料。根据FET前输卵管积水的不同处理方式,分为穿刺抽吸组(于FET周期胚胎移植日行输卵管积水穿刺抽吸术,n=34)、手术结扎组(移植前至少一周期行腹腔镜下输卵管近端结扎术,n=39)。比较两组患者一般情况及FET周期临床结局等。结果两组患者间年龄、不孕年限、基础FSH水平、促排卵时间、Gn量、获卵数、成熟卵率、受精率、可用胚数、移植胚胎数等均无统计学差异(P>0.05);与手术结扎组比较,穿刺抽吸组胚胎着床率(26.56%vs.32.39%)、临床妊娠率(44.12%vs.53.85%)、异位妊娠率(0.00%vs.4.76%)均趋低,而多胎妊娠率(13.33%vs.9.50%)、流产率(20.00%vs.14.28%)均趋高,但差异均无统计学意义(P>0.05)。结论FET周期胚胎移植日抽吸输卵管积水后移植囊胚可获得与腹腔镜下近端结扎预处理者相当的妊娠结局,方法更简便、安全、经济,效果确切,可作为新的良好的替代方案。

Objective:To investigate the effect of hydrosalpinx aspiration on day of frozen-thawed embryo transfer(FET)on pregnancy outcome.Methods:The data of 73 patients who underwent IVF-ET for assist reproduction and complicated with visible hydrosalpinx before transplantation from January 2015 to June 2018 were retrospectively analyzed.According to the different treatment methods of hydrosalpinx before frozen-thawed embryo transfer,the patients were divided into two groups:hydrosalpinx aspiration group(hydrosalpinx aspiration on day of FET n=34),and tube ligation group(laparoscopic proximal tubal ligation at least one week before embryo transfer,n=39).The general condition and clinical outcomes of FET were compared between the two groups.Results:There was no significant difference in age,infertility years,basal FSH level,ovulation induction time,Gn amount,number of oocytes retrieved,matured oocyte rate,fertilization rate,number of embryos available and number of embryos transfer between the two groups(P>0.05).Compared with group B,the embryo implantation rate(26.56%vs.32.39%),clinical pregnancy rate(44.12%vs.53.85%),and ectopic pregnancy rate(0.00%vs.4.76%)were decreased in group A,while the multiple pregnancy rate(13.33%vs.9.5%)and miscarriage rate(20.00%vs.14.28%)were increased,but the difference was not significant(P>0.05).Conclusions:The blastocysts transfer after aspiration of hydrosalpinx on the day of frozen-thawed embryo transfer can achieve the pregnancy outcome comparable to that of pretreatment of proximal ligation under laparoscope.The method is simpler,safer,and more economical and has a more definite effect.It can be used as a good new alternative.