摘要
目的探讨单角子宫不孕患者行辅助生殖助孕情况。方法回顾分析行体外受精-胚胎移植/卵泡浆单精子注射-胚胎移植(IVF/ICSI-ET)的50例单角子宫患者(观察组)的临床资料。利用SAS软件对妊娠年龄、不孕年限、孕前体质指数等影响助孕结局的因素按1∶3比例进行Case control matching匹配,选取150例同时期的不孕患者作为对照组。分别比较两组不孕患者的助孕情况及妊娠结局。结果(1)两组患者基线资料包括年龄、不孕年限、体质指数、抗苗勒管激素(AMH)、基础卵泡刺激素(FSH)、不孕类型、不孕因素、平均获卵数、可利用胚胎数、优质胚胎数、移植胚胎数和HCG日子宫内膜厚度均差异无统计学意义(P>0.05)。(2)观察组50例患者行85个胚胎移植周期,临床妊娠23例共32个周期,其胚胎种植率为28.67%(41/143),移植周期临床妊娠率37.65%(32/85);对照组患者150例行288个胚胎移植周期,临床妊娠126例共156个周期,胚胎种植率为34.25%(186/543),移植周期临床妊娠率54.17%(156/288)。观察组患者临床妊娠率明显低于对照组(P<0.05);(3)相对于对照组患者,观察组患者晚期流产率(28.13%,9/32)(P=0.027)和剖宫产率(70.59%,12/17)(P<0.001)显著升高,足月产率(37.50%,12/32)(P=0.032)显著降低,观察组患者平均孕周(36.01±2.23)周(P=0.039)更小,累积活产率更低(21.18%,18/85)(P=0.002),余差异均无统计学意义(P>0.05)。结论单角子宫并不影响卵巢储备及促排卵巢反应性和胚胎培养结果,但降低IVF/ICSI助孕的临床妊娠率和累积活产率,增加妊娠流产及新生儿低出生体重风险。
Objective A retrospective analysis was performed to evaluate the reproductive outcome of 50 women with unicornuate uterus who underwent in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)and embryo transfer(ET).Methods Fifty patients who with unicornuate uterus underwent IVF/ICSI-ET were chosen as observation group.A total of 150 patients without uterine malformation matched by age,infertility duration,body mass index(BMI)were chosen as control group.Their clinical and laboratory data,miscarriage rate,preterm delivery rate,term delivery rate,weight of newborn,gestation weeks and delivery mode were compared.Results There was no significant difference in age,BMI,basal FSH,AMH,causes and types of infertility,the number of oocytes retrieved,good quality embryo rate,number of embryos transferred,or thickness of endometrium on HCG day between the two groups.Compared with patients without uterine malformation,patients with unicornuate uterus had significantly lower clinical pregnancy rate per embryo transfer(37.65%vs.54.17%,P=0.026)and cumulative pregnancy rate(21.18%vs.38.54%,P=0.002),as well as higher late miscarriage rate(28.13%vs.11.90%,P=0.027)and cesarean section rate(70.59%vs.13.51%,P<0.001).The average termination gestational age(36.21±0.69 weeks vs.38.52±1.77 weeks,P=0.032)between the two groups was statistically different.There was no ectopic pregnancy in patients with unicornuate uterus.Conclusion Clinical pregnancy rate,late miscarriage rate and perinatal outcome are worse in patients with unicornuate uterus compare with patients without uterine malformation.
作者
吴耀球
蓝洁
林海燕
焦雪丹
张清学
WU Yao-qiu;LAN Jie;LIN Hai-yan;JIAO Xue-dan;ZHAGN Qing-xue(Reproductive Medicine Center,Sun Yat-sen Memorial Hospital of SunYat-sen University,Guangzhou 510120,Guangdong,China)
出处
《广东医学》
CAS
2021年第8期883-887,共5页
Guangdong Medical Journal
基金
中山大学临床医学研究5010项目(20160045010)。
