体外受精-胚胎移植术后输卵管妊娠的危险因素分析

Risk factors of tubal pregnancy after in vitro fertilization embryo transfer

目的分析体外受精-胚胎移植(IVF-ET)术后输卵管妊娠的危险因素。方法选取170例IVF-ET术后妊娠患者,所有患者均实施促性腺激素释放激素激动剂(GnRH-a)降调节,采用多因素Logistic回归分析IVF-ET术后输卵管妊娠的危险因素。结果170例IVF-ET妊娠患者中,异位妊娠患者64例,占37.65%。其中输卵管妊娠患者46例,占71.88%;宫内宫外妊娠患者18例,占28.12%。输卵管妊娠患者流产史、异位妊娠史、输卵管整形史、子宫肌瘤剔除史及输卵管积水发生率较高,差异有统计学意义(P<0.05)。多因素Logistic分析显示:流产史、输卵管整形史及输卵管积水是导致IVF-ET术后发生输卵管妊娠的独立危险因素。结论IVF-ET术后发生输卵管妊娠的影响因素较多,其中流产史、输卵管整形史及输卵管积水是导致输卵管妊娠的危险因素。

Objective To analyze the risk factors of tubal pregnancy after in vitro fertilization embryo transfer(IVF-ET).Methods 170 patients with pregnancy after IVF-ET were selected,all of whom were treated with gonadotropin releasing hormone agonist(GnRH-a).Multivariate logistic regression was used to analyze the risk factors of tubal pregnancy after IVF-ET.Results Among 170 cases of IVF-ET pregnancy,64 cases were ectopic pregnancy,accounting for 37.65%.Among them,46 cases were tubal pregnancy,accounting for 71.88%;There were 18 cases of ectopic pregnancy,accounting for 28.12%.The incidence of abortion,ectopic pregnancy,tubal plastic surgery,myomectomy and hydrosalpinx in patients with tubal pregnancy was higher,and the difference was statistically significant(P<0.05).Multivariate logistic analysis showed that the history of abortion,tubal plastic surgery and hydrosalpinx were independent risk factors for tubal pregnancy after IVF-ET.Conclusion There are many influencing factors of tubal pregnancy after IVF-ET,among which the history of abortion,tubal plastic surgery and hydrosalpinx are the risk factors of tubal pregnancy.