体外受精-胚胎移植术后异位妊娠35例临床分析

目的:探讨体外受精-胚胎移植(IVF-ET)术后异位妊娠的发生率、高危因素、早期诊断方法。方法:对生殖中心2001～2007年接受IVF-ET术后异位妊娠资料进行回顾性分析。结果:同期IVF-ET后临床妊娠1082例,异位妊娠35例,发生率3.2%,其中宫内外同时妊娠9例,发生率0.8%。异位妊娠组输卵管因素,近距离移植胚胎率均显著高于宫内妊娠组。单纯宫外妊娠与宫内外同时妊娠比较,胚胎移植14天血β-HCG及移植4周后常规阴道B超确诊率,差异有统计学意义。结论:输卵管因素是IVF-ET后发生异位妊娠主要高危因素,同时与移植管顶端在宫腔内位置有关。宫内外同时妊娠首次B超漏诊率高。IVF-ET术前、术中适当处理,早诊断、早处理有助于降低危害。

Ectopic pregnancy after in vitro fertilization and embryo transfer:a clinical analysis of 35 cases

Objective:To investigate the incidence,high risk factors and clinical characteristics of heterotopic pregnancy(HP) after in-vitro fertilization and embryo transfer(IVF-ET).Methods:All cases of HP after IVF-ET in the center were analyzed retrospectively from 2001 to 2007.Results:Clinical data of 35 cases with HP out of 1 082 clinical pregnant women after IVF-ET were analyzed retrospectively,and the occurrence rate was 3.2%.9 pregnant women got both HP and intrauterine pregnancy,and the occurrence rate was 0.8%.The rates of tubal diseases and short distance embryo transfer in HP patients were higher than those in intrauterine pregnant patients.The diagnosis rates of serum β-HCG value on the fourteenth day after embryo transplant and B-ultrasound results on the fourth week after embryo transplant in HP patients were both significantly higher than those in patients both with HP and intrauterine pregnancy.Conclusion:Tubal diseases are the major high risk factors of HP after IVF-ET,and the site of embryo transfer also impact the HP incidence.The misdiagnose rate of first B-ultrasound in the patients both with HP and intrauterine pregnancy are high.Early diagnosis and prompt treatment can reduce the risks.