不同病因对体外受精-胚胎移植的影响

目的 探讨不同病因对体外受精-胚胎移植的影响。方法 回顾分析2004年1月～12月行体外受精-胚胎移植治疗的234个周期的资料。将女方致不孕的主要因素分5组，A组：双侧输卵管阻塞或缺如或双侧输卵管结扎术后，共86个周期；B组：一侧或双侧输卵管炎，共79个周期；C组：一侧或双侧输卵管积水，共24个周期；D组：子宫内膜异位症或子宫腺肌症，共24个周期；E组：多次人工受精失败行体外受精-胚胎移植，共21个周期。比较5组间的受精率、卵裂率、胚胎种植率、临床妊娠率、早期流产率及宫外孕率。结果 各组间受精率、卵裂率、胚胎种植率比较，无显著性差异（P〉0．05）。临床妊娠率，A组显著高于C、D组（P〈0．05）。流产率，E组显著高于A、B组，D组高于B组（P〈0．05）。宫外孕率，A组显著低于C组。结论 在体外受精-胚胎移植治疗之前应针对病因预防性治疗，以改善体外受精-胚胎移植的妊娠结局。

The Effect of Etiological Factors on the Pregnancy Rate of in Vitro Fertilization and Embryo Transfer (IVF-ET)

Objective To study the effect of etiological factors on pregnancy rate of in vitro fertilization and embryo transfer. Methods Data of 234 cycles of IVF-ET, which were performed in the Guangdong Jiai Genetics & IVF Institute from January to December in 2004, were analyzed retrospectively. Patients were divided into five groups according to the female factors. Group A: 86 cycles with both tubal obstruction or after tubal sterilization; group B: 79 cycles with one or two side tubal salpingitis; group C: 24 cycles with one or two side hydrosalpinx; group D: 24 cycles with endometriosis; group E: 21 cycles with artificial insemination by husband (AIH) failure for more than three times. Fertilization rate, cleavage rate, implantation rate and clinical pregnancy rate, miscarriage rate, ectopic pregnancy rate of the five groups were compared. Results There is no difference in fertilization rate, cleavage rate and implantation rate between five groups. The clinical pregnancy rate of group A is higher than that of group C and group D (P<0.05). The miscarriage rate of group E is higher than group A and group B, while group D is higher than group B (P<0.05). The ectopic pregnancy rate of group A is lower than group C (P<0.05). Conclusion To improve the IVF-ET result, we may treat the couples according to the sterility factors before IVF-ET.