经阴道配子输卵管内移植42例临床分析

目的开展经阴道配子输卵管内移植（ｔｒａｎｓｖａｇｉｎａｌｇａｍｅｔｅｉｎｔｒａｆａｌｏｐｉａｎｔｒａｎｓｆｅｒ,ＴＶＧＩＦＴ）技术并探讨其实用价值。方法１９９６年５月至１９９７年１０月,对证实至少有一条以上输卵管正常的不孕患者４２例（４３个周期）,采用卵泡刺激素、绝经期促性腺激素、人绒毛膜促性腺激素（ＦＳＨｈＭＧ／ｈＣＧ）及ｈＭＧ／ｈＣＧ超排卵方案,经阴道穿刺取卵,改良上游法处理精液,以ＪａｎｓｅｎＡｎｄｅｒｓｅｎ输卵管导管系统行ＴＶＧＩＦＴ,平均移植卵子（４．０±０．９）个／周期。结果输卵管插管成功率６７．４％（２９／４３）,临床妊娠１３例,双胎５例,周期妊娠率３０．２％（１３／４３）;９例分娩（出生婴儿１３个）,４例流产。结论ＴＶＧＩＦＴ适用于至少一侧输卵管通畅的不孕患者,技术简便,易于掌握,无需开腹及腔镜操作,有较高的妊娠成功率,值得开展推广

Transvaginal gamete intrafallopian transfer: an analysis of 42 cases

Objective To develop the technique of transvaginal gamete intrafallopian transfer (TVGIFT) and to evaluate its effectiveness. Methods From May, 1996 to October, 1997, 42 infertile patients with at least one tube patent, proven by hysterosalpingography were included. In 43 cycles, ovarian stimulation was performed by using folliclestimulating hormone (FSH), human menopausal gonadotropin (hMG)/hCG or hMG/hCG program. Oocytes retrieval was performed by transvaginal ultrasound guided needle aspiration. Semen samples were prepared by modified swimup method. The JansenAndersen tubal catheter was introduced into a fallopian tube transvaginally, and the gametes were injected into the tube. Results Transvaginal cannulation was successfully performed in 67.4% of cases. The mean number of oocytes transferred was 4.00.9 (26) per cycle. 13 cases obtained clinical pregnancy (30.2% per cycle), 9 given birth with 5 twin pregnancies (altogether 13 babies), 4 spontaneous abortions. Conclusions TVGIFT offers an acceptable pregnancy rate for patient with at least one patent tube. The procedure is simple and easy to perform and therefore, is worth to recommend for the treatment of infertility.