体外受精-胚胎移植失败202例宫腔镜检结果分析

目的:评价体外受精(IVF)-胚胎移植(ET)失败患者的宫腔情况,探讨宫腔镜对分析IVF-ET失败的应用价值.方法:对202例接受常规体外受精或卵胞浆内单精子注射(ICSI)-ET失败患者再次助孕前行宫腔镜检查,对异常宫腔患者进行相应治疗后再次助孕.结果:正常宫腔115例(56.9%),异常宫腔87例(43.1%).异常宫腔中以子宫内膜息肉、子宫内膜薄、子宫内膜炎多见,共占76.9%.年龄≥35岁与子宫内膜厚度＜8 mm者异常宫腔发生率高(P＜0.05).异常宫腔患者经相应治疗后再次助孕临床妊娠率与正常宫腔者相似(P＞0.05).结论:IVF/ICSI失败患者宫腔异常发生率较高,特别是≥35岁者.IVF/ICSI失败后宫腔镜检查对提高再次助孕妊娠率具有重要意义.

Analysis of uterine cavity of patients underwent failed attempts of in vitro fertilization-embryo transfer by hysteroscopy

Aim: To evaluate uterine cavity of the patients who underwent one or more failed attempts of in vitro fertilization-embryo transfer(IVF-ET) and determine the value of hysteroscopy prior to another cycle of assisted conception. Methods: A total of 202 patients who had undergone one or more failed attempts of IVF/ICSI underwent hysteroscopy, and appropriate medical or surgical treatment was given to the patients with uterine abnormalities before entering another cycle of assisted conception. Results: Of 202 patients, 115 patients (56.9%) had normal cavities and 87 patients (43.1%) had abnormal findings maily including endometrial polyps, thin endometrium, and endometritis which accounted for 76.9%. The incidence of intrauterine pathology was significantly higher in the patients more than 35 years old and with endometriual thickness less than 8 mm by intravaginal ultrasound (P<0.05). In the patients who had been treated appropriately, clinical pregnancy rate was similar to those patients with normal cavity(P>0.05). Conclusion: Uterine cavity assessment should be routinely performed in patients undergoing failed attempts of IVF, which is helpful in increasing pregnancy rate in next IVF treatment.