宫腔镜用于重复体外受精-胚胎移植的临床观察

目的探讨宫腔镜在体外受精-胚胎移植（IVF—ET）失败后再次行辅助技术治疗中的应用价值。方法随机抽取IVF-ET失败后准备再次治疗的患者167例，根据有否行官腔镜检查分为观察组97例，对照组70例。再根据宫腔镜检查结果分为宫腔异常组和官腔正常组。比较观察组与对照组、异常组与正常组再次IVF—ET的临床妊娠率。分析不同官腔疾患经纠正治疗后再次IVF—ET的效果。结果宫腔异常率44．3％（43／97），主要是微小病变，包括：子宫内膜息肉、内膜炎、子宫黏膜下小肌瘤、宫腔轻度粘连、子宫内膜单纯增生过长及息肉样增生。再次IVF—ET临床妊娠率：观察组与对照组分别为35．1％、22．9％；宫腔异常组与官腔正常组分别为48．1％、24．1％，差异均有统计学意义（均P〈0．05）。经宫腔镜处理治疗后，子宫内膜息肉、子宫黏膜下小肌瘤、子宫内膜息肉样增生、内膜单纯性增生过长的临床妊娠率高于宫腔粘连及子宫内膜炎，分别为75．0％、103．0％、66．7％、50．0％、11．1％、33．3％。结论宫腔镜能准确诊断处理宫内微小病变，提高再次IVF-ET的临床妊娠率。

Application of hysteroscopy in recurrent in vitro fertilization-embryo transfer

Objective To investigate the applied value of hysteroscopy in in vitro fertilization-embryo transfer (IVF-ET) after recurrent 1VF-ET failures.Methods 167 patients who had been recurrent failure in IVF-ET were randomly enrolled in this research.They were divided into 97 cases of study group and 70 cases of control group.According to the results of the hysteroscopy, the study group included the normal uterine cavity and abnormal uterine cavity.The clinical results were compared in study group and control group, abnormal group and normal group.The clinical results were analyzed after treatment of abnormal uterine cavity.Results Abnormal rate of hysteroscopy was 44.3% (43/97) ,the abnormality were mainly minimal lesions including endometrial polyps, endometritis.submucous myoma,endometrial adhesion, simple and polypoid hyperplasia of endometium.After another IVF-ET, The pregnant rate were significantly different(35.1% vs 22.9% ) between study group and control group,and significantly different (48.1 % vs 24.1 % ) between abnormal group and normal group(all P < 0.05).After treatment, the pregnant rate was higher in endometrial polyps (75.0% ), submucous myoma (100.0% ), simple polypoid hyperplasia of endometium (66.7% ) .simple hyperplasia(50.0% ) than endometrial adhesion(11.1% ) and endometritis(33.3% ).Conclusion Hysteroscopy can accurately diagnose lesions in uterine cavity and increase clinical pregnant rate in IVF-ET.