宫腔镜下近端输卵管栓塞术在输卵管积水患者体外受精-胚胎移植前的应用价值

目的：探讨和评价宫腔镜下近端输卵管栓塞术在输卵管积水患者行体外受精-胚胎移植（IVF-ET）前的应用价值。方法：将2015年1月-2016年12月在沈阳东方医疗集团菁华医院IVF-ET术前因输卵管积水实施宫腔镜下近端输卵管栓塞术的患者100例列为A组，并随机抽取同期IVF-ET术前因输卵管积水行腹腔镜下近端输卵管根部结扎术+伞端造口术的72例患者列为B组。A组患者新鲜胚胎移植67个周期，囊胚复苏移植76个周期。B组患者新鲜胚胎移植72个周期，囊胚复苏移植64个周期。比较2组患者的手术相关数据，2种移植周期的受精率、优胚率、妊娠率、流产率以及出生情况。结果：A组手术时间（21.18±7.89）min明显低于B组（44.56±20.30）min；2组的优胚率、新鲜胚胎妊娠率、新鲜胚胎流产率、新鲜胚胎早产率以及囊胚复苏妊娠率、囊胚复苏流产率、囊胚复苏早产率差异均无统计学意义（P＞0.05）。结论：对于输卵管积水患者，宫腔镜下输卵管栓塞术与腹腔镜下输卵管根部结扎术的IVF-ET临床结局相似。宫腔镜下输卵管栓塞术具有操作简便、创伤小、手术时间短、无需全身麻醉、可门诊进行手术等优点。

Application of Hysteroscopic Tubal Occlusion in Patients with Hydrosalpinx before in vitro Fertillization and Embryo Transfer

Objective:To evaluate the application of hysteroscopic tubal occlusion in those patients with hydrosalpinx before in vitro fertilization and embryo transfer (IVF-ET).Methods:One hundred and seventy two cases of hydrosalpinx were retrospectively analyzed in our hospital from 2015 to 2016.A total of 100 cases were performed hysteroscopic tubal occlusion (the group A) before IVF-ET,with 67 cycles of fresh embryo transfer and 76 cycles of blastocyst embryo transfer.Seventy two cases were performed laparoscopic proximate tubal ligation (as the group B) before IVF-ET,with 72 cycles of fresh embryo transfer and 64 cycles of blstocyst embryo transfer.The operation time,fertilization rate,high quality embryo rate,clinical pregnancy rate and abortion rate were analyzed.Results:The operation time in the group A was less than that in the group B [(21.18±7.89) min vs (44.56±20.30) min,P＜O.O01].There were no significant differences in the fertilization rate,high quality embryo rate,clinical pregnancy rate,abortion rate and miscarriage rate between the two groups (P＞0.05).Conclusions:The pregnancy outcome in those patients with hydrosalpinx who underwent the hysteroscopic tubal occlusion before IVF-ET was same as that in those laparoscopic proximate tubal ligation.Hysteroscopic tubal occlusion is a simple surgery with the advantages of minimal invasive,short operation time,no need of general anesthesia.and outpatient operation.