体外受精-胚胎移植技术中74例异位妊娠的临床分析

目的:分析体外受精-胚胎移植(in vitro fertilization and embryo tranfer,IVF-ET)助孕技术中发生异位妊娠的影响因素、诊断、治疗方法及预防措施。方法:回顾性分析IVF-ET助孕技术中发生异位妊娠74例患者的临床资料。结果:所有接受IVF-ET的1 585患者中,共发生异位妊娠74例,异位妊娠发生率为4.67%;异位妊娠类型中输卵管妊娠71例,占总异位妊娠的95.95%。新鲜胚胎移植周期组异位妊娠发生率(5.41%)显著性高于冷冻胚胎复苏移植(frozing embryo transfer,FET)周期组(2.35%)(P<0.05)。移植深度距离宫底>1.2 cm时异位妊娠发生率显著性低于移植深度0.8~1.2 cm组。结论:IVF-ET助孕技术中异位妊娠发生率较自然妊娠过程中高;输卵管因素、促排卵药物的应用以及胚胎移植的深度是异位妊娠发生的主要影响因素。

Analysis of 74 cases ectopic pregnancy in in vitro fertilization and embryo transfer

Objective: To investigate the influential factors,diagnosis and treatment of ectopic pregnancy received in vitro fertilization and embryo transfer(IVF-ET) and to discuss the methods on how to prevent ectopic pregnancy.Methods: A retrospective study of ectopic pregnancy during IVF-ET was performed.Result: A total of 74 cases of ectopic pregnancy happened among 1 585 cases of clinical pregnancy patients,the occurrence rate was 4.67%;71 cases ectopic pregnancy were tubal pregnancy,which constituted 95.95% of all ectopic pregnancy.There was significant difference on occurrence rate of ectopic pregnancy between the fresh embryo transfer(5.14%) and thawing embryo transfer(2.35%)(P<0.05).According to the distance to fundal endometrium,the patients were divided into 2 groups,the occurrence rate of ectopic pregnancy in group B(>1.2 cm) was significant lower than that in group A(0.8-1.2 cm).Conclution: The occurrence rate of ectopic pregnancy in IVF is higher than that of spontaneous pregnancy.Tubal pathological changes,controlled ovarian hyperstimulation and the depth of embryo transfer are the main causes of ectopic pregnancy.