辅助生殖技术助孕后不同步异位妊娠原因探究及文献回顾

目的:探讨辅助生殖技术(ART)能够降低异位妊娠风险的预防、治疗措施。方法:报道2例国内外少见的不同步异位妊娠病例,并结合近年来相关的5个案例进行回顾性分析。结果:不同步异位妊娠成因复杂,自然受孕及ART助孕都可发生,最迟可发生在初次异位妊娠后1个月左右,且往往需要2次手术治疗。结论:对有相应适应证的患者,输卵管抽芯切除作为预处理或冻融单囊胚移植可降低不同步异位妊娠的发生率;异位妊娠手术处理后1个月左右均需密切监测患者情况,尽早发现不同步异位妊娠病灶并给予及时处理。

Investigation and literature review about heterochronic ectopic pregnancy after ART

Objective:To discuss the prevention and treatment measures that can reduce the risk of ectopic pregnancy of assisted reproductive technology (ART).Methods:Two unusual cases of heterochronic ectopic pregnancy have been reported.A retrospective clinical study was performed to analyze the five relevant cases in recent years.Results:The cause of heterochronic ectopic pregnancy was complicated.This kind of ectopic pregnancy could be spontaneously or related to ART.It could be happened about one month after the first ectopic pregnancy at the latest,and the patient was often required the second surgical treatment.Conclusion:The patient with tubal factor can be treated with laparoscopic "core-pulling" salpingectomy before IVF.Vitrified-thawed singleblastocyst was another great solution to reduce the potential heterochronic ectopic pregnancy rates.The patient should be monitored continuously after the operation of ectopic pregnancy a month or so,heterochronic ectopic pregnancy should be discovered and treated timely.