输卵管积水及其处理方法对冻融胚胎移植妊娠结局的影响

目的:讨论输卵管积水及其处理方法对冻融胚胎移植(FET)周期妊娠结局的影响。方法:对FET304个周期进行回顾性分析,观察组43周期,为FET周期中阴道B超检查提示输卵管积水者;对照组261周期,为B超检查无输卵管积水者。同时按积水的处理方式将观察组分为3组:A组29例,FET前行积水抽吸术;B组3例,FET前行双侧输卵管近端结扎术;C组11例,采用药物理疗。结果:观察组种植率、妊娠率(8.43%,23.79%)低于对照组(16.28%,39.85%),差异有统计学意义(P0.05);而流产率、异位妊娠率(2.33%,8.81%)与对照组(1.91%,2.32%)比较,差异无统计学意义(P0.05);A、B组与C组进行种植率、妊娠率、流产率、异位妊娠率的比较(6.67%,16.67%,13.04%;13.7%,33.33%,18.18%;3.45%,0%,0%;3.45%,0%,0%),差异均无统计学意义(P0.05)。结论:输卵管积水可明显降低FET种植率及妊娠率,而进行输卵管积水抽吸术未能明显改善FET的妊娠结局,行输卵管近端结扎术处理积水因例数较少,有待进一步探讨。

Influence of hydrosalpinx and the treatment strategy on pregnancy outcome in the frozen-thawed embryo transfer cycles

Objective：To determine the influence of hydrosalpinx and the treatment strategy on pregnancy outcome in the frozen-thawed embryo transfer（FET）cycles. Methods：A total of 304 FET cycles were retrospectively analyzed. The patients were divided into two groups. The study group （hydrosalpinx group） suffering from hydrosalpinx diagnosed by transvaginal sonography underwent 43 FET cycles; the control group having no sign of hydrosalpinx by vaginal ultrasound underwent 261 cycles. And the control group was further divided into three groups according to the treatment strategy of hydrosalpinx：group A （29 women） were treated with hydrosalpinx aspiration before FET; group B （3 women） were treated with bilateral tubal ligation before FET; group C （11 women） were treated with medicine and physiotherapy. Results：The implantation and pregnancy rate in the study group were significantly lower than those of the control group （8.43% vs. 16.28%,23.79%vs. 39.85%,P〈0.05）. However,there were no significant differences in the miscarriage rate and the rate of ectopic pregnancy （2.33% vs. 1.91%,18.8% vs. 2.32%,P〉0.05）. There were no significant differences in the implantation rate,pregnancy rate,miscarriage rate and ectopic pregnancy rate among group A,B and C （P〉0.05）. Conclusion：Hydrosalpinx can significantly reduce the implantation rate of frozen embryo and the pregnancy rate,but hydrosalpinx aspiration failed to significantly improve the pregnancy outcome of frozen embryo. Further research should be conducted on tubal ligation used for dealing with hydrosalpinx.