摘要
目的：探讨子宫畸形合并不孕患者进行体外受精/单精子卵胞浆注射-胚胎移植（IVF/ICSI-ET）助孕的结局,以及移植胚胎的数量对临床结局的影响。方法：回顾性分析2012年1月~2013年8月行IVF/ICSI-ET助孕的子宫畸形患者临床资料。按照子宫畸形的类型分单角子宫组（24例）、纵隔子宫组（45例）、双子宫组（17例）、双角子宫组（9例）、鞍状子宫组（4例）,比较各组基本资料及辅助生殖技术（ART）治疗结局。同时对助孕周期按照移植胚胎1、2、3枚分为3组,分析妊娠结局。结果：子宫畸形合并不孕患者共99例,行IVF/ICSI-ET治疗周期151个,周期妊娠率、种植率分别为32.45%、19.93%,流产率为40.82%。5组妊娠率、种植率、多胎率、出生率、出生孕周、出生体重比较均无统计学差异（P〉0.05）。鞍状子宫组无流产、早产发生,2例妊娠均为足月产。单角子宫组、纵隔子宫组与双角子宫组、双子宫组相比,流产率增高（66.67%、55%与25%、20%）,足月产率降低（38.46%、40%与50%、60%）,但差异均无统计学意义（P〉0.05）。移植不同胚胎数组妊娠率、种植率、出生率无统计学差异（P〉0.05）,1枚组无流产,2枚组与3枚组的多胎率、流产率均无统计学差异（P〉0.05）。结论：子宫畸形患者行IVF/ICSI-ET助孕的临床妊娠率和种植率低于普通不孕患者,流产率高于普通不孕患者。鞍状子宫患者助孕后临床结局较好,而单角子宫、纵隔子宫患者助孕后临床结局不佳。建议对子宫畸形的不孕患者行ART助孕应该限制移植胚胎数,对多胎妊娠进行早期减胎术,以减少流产、早产的发生,提高助孕结局。
Objective：To explore reproductive outcomes of infertile women with congenital uterine malformation who underwent in vitro fertilization（IVF）or intracytoplasmic sperm injection（ICSI）and embryo transfer（ET）,and to evaluate the effect of the number of transferred embryos on the clinical outcome.Methods：Clinical data of 99 infertile patients with congenital uterine malformation who underwent IVF/ICSI-ET from Jan 2012 to Aug 2013 were studied retrospectively.Patients were grouped according to the following types of uterine malformation：24 unicornate,45 septate,17didelphys,9 bicornuate,4 arcuate.Their clinical data and outcomes were compared.The IVF/ICSI-ET cycles were grouped according to the number of transferred embryos：single,double and triple.Clinical outcomes were compared.Results：We conducted a retrospective analysis of data from 99 patients undergoing 151IVF/ICSI-ET cycles.Patients with uterine malformation had lower pregnancy rate（32.45%）and implantation rate（19.93%）than those without malformation（P〈0.05）.Compared with patients without malformation,patients with uterine malformation had higher miscarriage rate（40.82%,P〈0.05）.There were no significant differences in pregnancy rate,implantation rate,multiple pregnancy rate,baby take-home rate,gestation weeks,weight of newborn when the various types of uterine malformation were compared（P〉0.05）.Patients with arcuate uterus had no miscarriage and premature delivery and 2 clinical pregnancies were full-term birth.Patients with unicornate uterus and septate uterus had higher miscar-riage rate and lower full-term birth rate when compared with those with bicornuate uterus and didelphys uterus（66.67%,55.00%vs.25.00%,20.00%;38.46%,40.00%vs.50.00%,60.00%）,but the differences had no statistical significance（P〉0.05）.There were no significant differences in pregnancy rate,implantation rate,baby take-home rate among three groups according to the number of transferred embryos（P〉0.05）.Patients in single embryo transfer group had no multiple pregnancy and miscarriage.There were no significant differences in multiple pregnancy rate and miscarriage rate between double embryo transfer group and triple embryo transfer group（P〉0.05）.Conclusion：Clinical pregnancy rate and implantation rate are worse and the incidence of miscarriage is higher in patients of uterine malformation compare with patients without malformation.Patients with arcuate uterus have better clinical outcomes than those with unicornate uterus and septate uterus.The number of transferred embryos should be limited in the patients of uterine malformation and multiple pregnancy should be reduced to decrease the occurrence of miscarriage and premature delivery and improve the pregnancy outcome.
出处
《中国计划生育学杂志》
2015年第6期387-391,共5页
Chinese Journal of Family Planning
