IVF-ET后早期自然流产病人宫腔镜检查结果分析

目的分析实施体外受精-胚胎移植（IVF-ET）后早期自然流产病人宫腔镜检查结果。方法回顾我院2004年1月—2007年12月间实施IVF-ET后早期自然流产行宫腔镜检查病人84例的临床资料,分析宫腔镜检查结果,对发现的宫腔病变进行治疗,观察再次移植后的妊娠结局。结果 84例中58例（69.05%）存在宫腔病变,其中宫腔粘连32例（38.10%）,子宫内膜息肉12例（14.29%）,子宫内膜炎10例（11.90%）,黏膜下子宫肌瘤3例（3.57%）,部分性子宫纵隔1例（1.19%）。58例病人经治疗后于1年内进行再次IVF-ET,22例（37.93%）获得临床妊娠,宫外孕2例（3.45%）;早孕自然流产1例（4.55%）,分娩21例（95.45%）。结论在IVF-ET中出现早期自然流产时应将宫腔镜检查列为首选干预措施,对宫腔异常病人治疗后可以改善妊娠结局。

AN ANALYSIS OF HYSTEROSCOPIC FINDINGS IN PATIENTS WITH EARLY SPONTANEOUS ABORTION AFTER IN VITRO FERTILIZATION AND EMBRYO TRANSFER

Objective To analyze the findings of hysteroscopy in patients with early spontaneous abortion（SA） after in vitro fertilization and embryo transfer（IVF-ET）. Methods A retrospective study was done in 84 patients undergoing hysteroscopy because of early SA after IVF-ET during January 2004-December 2007.The results were analyzed,the diseases of uterine cavity were treated and the pregnancy outcome of retransplantation observed. Results Of 84 patients,intrauterine pathological changes were found in 58（69.05%）,in which,intrauterine adhesion 32,endometrial polyps 12,endometritis 10,submucous leiomyoma three and uterus septum,one.Of those after therapy a retransplantation was undertaken within one year,22 patients were pregnant,two with ectopic pregnancy,one with early SA,and delivery got in 21 cases. Conclusion Hysteroscopy should be the first choice for patients with early SA after IVF-ET.A perfect therapy for patients with abnormal uterine cavity may improve the pregnancy outcome.