阴道超声联合宫腔镜对体外受精-胚胎移植失败的诊治价值

目的探讨对体外受精-胚胎移植(IVF-ET)失败后行阴道超声联合宫腔镜检查的诊治价值。方法对65例IVF-ET失败者进行阴道超声联合宫腔镜检查及治疗,其中宫腔异常48例,与IVF-ET失败后未行阴道超声联合宫腔镜检查的42例比较再次IVF妊娠结局情况。结果阴道超声联合宫腔镜检查对子宫内病变检出率为73.85%,其中内膜息肉占48.21%,内膜炎占12.50%,内膜增殖症占17.86%,宫腔粘连占12.50%,黏膜下肌瘤占5.36%,子宫中隔占3.57%,宫腔异常组经处理后再次IVF临床妊娠率为52.08%,与对照组比较有统计学意义。结论体外受精-胚胎移植失败后于再次IVF治疗前可常规行阴道超声联合宫腔镜检查,以排除子宫内病变,提高助孕妊娠率。

Clinical Value of Transvaginal Ultrasound Combined with Hysteroscopy in Patients Who Failed in IVF-ET

Objective To study the clinical value of transvaginal ultrasound combined with hysteroscopy in patients who failed in in-vitro fertilization embryo transferred(IVF-ET).Methods 65 patients who failed in IVF were checked and treated by transvaginal ultrasound combined with hysteroscopy,including 48 cases of uterine cavity abnormalities,the second-time IVF pregnancy rate of which were compared with 42 cases without transvaginal ultrasound combined with hysteroscopy after first-time IVF pregnancy failure.Results The detection rate of intrauterine pathological change was 73.85% by transvaginal ultrasound combined with hysteroscopy,including 48.21% of endometrial polyps,12.50% of endometritis,17.86% of intimal hyperplasia,12.50% of intrauterine adhesions,5.36% of submucous myoma,and 3.57% of uterine septum.The rate of second-time IVF pregnancy after treatmentwas 52.08%,higher than in the control group with a significant difference.Conclusion Before subsequent IVF,transvaginal ultrasound combined with hysteroscopy should be used as a routine in the patient who failed in IVF-ET in order to exclude uterine lesions and increase the aided pregnancy rate.