体外受精-胚胎移植助孕失败后宫腔镜检查108例临床分析

目的：探讨体外受精-胚胎移植助孕失败患者行宫腔镜检查的临床意义及合适的检查时机。方法选取2009~2012年在我院生殖医学中心行IVF助孕治疗失败后行宫腔镜检查的患者为A组，共108例；选取同期无胚胎移植史在我院行宫腔镜检查的不孕症患者为对照B组，共84例，比较两组宫腔镜检查的结果。结果 A组中，影响胚胎种植的宫腔内膜异常病变的总发现率高于B组，差异有统计学意义（P〈0.05）。其中，A组中子宫内膜息肉、子宫内膜炎、宫腔粘连及子宫内膜不规则增生的发现率高于B组（P〈0.05）。两组在子宫纵隔和子宫粘膜下肌瘤的发现率比较，差异无统计学意义。结论在体外受精-胚胎移植反复失败患者可行宫腔镜检查发现可能影响胚胎种植的宫腔内病变的因素，有利于提高再次行IVF助孕的临床妊娠率。

Clinical analysis of hysteroscopy examination in 108 cases undergoing in vitro fertilization-embryo transfer failure

Objective To explore the clinical significance and appropriate time of hysteroscopy examination on patients undergoing in vitro fertilization-embryo transfer （IVF） failure. Methods Selected 108 cases undergoing IVF failure as group A, and 84 cases without the history of IVF as group B in our hospital from 2009 to 2012. Compared the data of hysteroscopy ex-aminations. Results The total detection rate of endometrial abnormality affecting embryo implantation in group A was signifi-cantly higher than that of group B（P〈0.05）. The discovery rate of endometrial polyps, uterine cavity adhesion, endometritis and endometrial irregular hyperplasia in group A was higher than those of group B（P〈0.05）. There was no difference in the discovery rates of uterine septum and submucosal myoma of uterus between the two groups. Conclusion Potential uterine cavity findings can be found by hysteroscopic interventions in patients undergoing IVF who repeatedly failed, that will improve clinical preg-nancy rate with IVF.