宫腔镜检查在胚胎移植前的应用价值

目的 了解冷冻胚胎移植（FET）前宫腔异常类型,评价FET前行宫腔镜检查的临床意义.方法 分析234例既往体外受精-胚胎移植（IVF-ET）失败者后准备行FET的患者,按其是否进行宫腔镜检查及治疗分为宫腔镜组114例和对照组120例,比较两组的妊娠结局,及宫腔镜组宫腔异常的检出率和异常类型.结果 宫腔镜组患者FET后临床妊娠率较对照组增高（49.12％ vs 31.67％,P＜0.05）,继发不孕患者宫腔异常检出率高于原发不孕者（49.09％vs 22.03％,P＜0.05）,其中以宫腔粘连、宫内膜息肉、息肉样增生多见.结论 宫腔镜能改善宫腔环境;宫腔镜检查及治疗后能提高IVF-ET的成功率,建议在FET之前行宫腔镜检查.

Clinical significance of hysteroscopy before the frozen-thawed embryo transfer

Objective To investigate the clinical significance of hysteroscopy before the frozen-thawed embryo transfer.Methods 114 patients were given hysteroscopic diagnosis and 120 patients without hysteroscopic diagnosis before the FET were retrospectively analyzed.The results of the incidences and types of abnormal hysteroseopie findings were compared.The clinical pregnancy rate of two groups was compared.Results In the FET cycle,the pregnancy rate was significantly higher in hysteroscopy group than that of the control group（49.12% vs 31.67%,P〈0.05）.The incidences of hysteroscopic abnormalities was significantly higher in hysteroscopy group than that of the control group （49.09% vs 22.03%,P〈0.05）.The incidence of uterine cavity adhesion and endometrial polyp were higher than the other types.Conclusion Hysteroscopy helps to check the endometrium and get rid of focal lesions at the same time.It helps to improve the pregnancy outcome of patients undergoing at least one time IVF failure.It is recommended hysteroscopy before the FET cycle.