摘要
目的 探讨输卵管积水的处理方法对此后的体外受精与胚胎移植 (IVF-ET)治疗效果的影响。方法 回顾分析 1999年 2月至 2001年 4月期间中山大学附属第一医院生殖医学中心 73例有输卵管积水病史者行IVF-ET治疗的 79个周期的资料。根据在IVF-ET前对患者的输卵管积水的处理方式分A组 27个周期 (25例 ):未经手术治疗行IVF ET;B组 25个周期(23例):已行双侧输卵管切除术;C组 27个周期 (25例 ):已行输卵管积水造口术。D组:以同期因其他输卵管因素行IVF-ET治疗的 913个周期 (875例 )的资料作为对照。结果 B组获卵数最少,较C、D组差异有显著意义(P<0.05);各组的胚胎植入率分别为 9 4%、11.5%、21.2%和 17.4%,A组与C、D组间差异有显著意义(P<0.05)。各组的流产率分别为 50.0%、33.3%、25.0%和 15.3%,A组与D组间的差异有显著意义(P<0.05)。结论 输卵管积水对IVF-ET的胚胎植入构成不良影响,并增加流产的发生,在采用IVF-ET前对输卵管积水进行适当处理,有助于提高胚胎植入率,改善治疗效果。较之输卵管切除术,输卵管造口术对卵巢功能的影响可能更小。
Objective To evaluate the effect of salpingectomy or salpingostomy for hydrosalpinx on the outcome of in Vitro fertilization and embryo transfer(IVF-ET).Methods The data of 79 cycles of IVF-ET,which were accomplished in the Reproductive Medicine Center of First Affiliated Hospital of Sun Yat-sen University during February 1999 and April 2001,from 73 cases of patients with a history of hydrosalpinx,were analyzed retrospectively.The data were divided into three groups.Group A included 27 cycles(25cases):no surgical procedure was adopted before IVF-ET.Group B included 25 cycles(23cases):a salpingectomy had been introduced to the patients before the IVF.Group C included 27 cycles(25cases):a salpingostomy had been introduced to the patients before the IVF.The control group was defined as group D and included 913 cycles of IVF-ET,which were accomplished in the same duration,from 875 patients with an indication of tubal factor other than hydrosalpix.Results The data revealed that fewer oocytes were retrieved in Group B and this was statistically significant(P<0.05).The embryo implantation rates in these four groups were 9.4%,11.5%,21.2% and 17.4%respectively.The difference between group A and group C,group A and the control group was statistically significant(P<0.05).The highest abortion rate found in group A was 50.0% and was statistically different from that in control group(P<0.05).Conclusion Hydrosalpinx is detrimental to the implantation of the embryos and may cause the increase of abortion.Appropriate procedure should be adopted to deal with the problem before the IVF-ET and it may enhance the embryo implantation and improve the outcome of IVF-ET.Compared with the salpingectomy,the salpingostomy may be a better option in this situation and it may cause less interference to the ovarian function.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2005年第3期155-157,共3页
Chinese Journal of Practical Gynecology and Obstetrics
关键词
体外受精
胚泡移植
妊娠
输卵管积水
Fertilization in vitro Embryo transfer Pregnancy Hydrosalpinx
