输卵管病变的预处理方式对胚胎移植后妊娠结局的影响
Effect of different laparoscopic procedures for hydrosalpinx on pregnancy outcome of embryo transfer
目的 探讨输卵管切除术和输卵管造口术对体外受精-胚胎移植(IVF-ET)妊娠结局的影响.方法 将2012年1月至2013年12月因输卵管因素不孕在浙江大学附属邵逸夫医院生殖医学中心行胚胎移植的447例患者分成两组:A组,腹腔镜下双侧输卵管切除术后269例;B组,腹腔镜下双侧输卵管造口术后178例.比较两组间鲜胚及冻胚周期的临床妊娠率、胚胎种植率、早期流产率、异位妊娠率及活产率.结果 两组间鲜胚及冻胚周期的移植胚胎数、移植优胚数、着床率、临床妊娠率、早期流产率、异位妊娠率以及活产及继续妊娠率比较,差异均无统计学意义(均P >0.05).双侧输卵管切除术后输卵管间质部妊娠率为10.27%(15/146).随着术后胚胎移植间隔时间的延长,输卵管切除术后临床妊娠率逐渐升高,输卵管间质部妊娠率逐渐下降,但差异无统计学意义(P>0.05).结论 作为输卵管病变的IVF前预处理,输卵管造口术与输卵管切除术在改善胚胎移植结局方面同样有效.输卵管切除后输卵管间质部妊娠发生率升高,输卵管切除后胚胎移植应与手术间隔适当时间.
更多Objective To explore the effects of different laparoscopic procedures before embryo transfer (ET) for hydrosalpinx on pregnancy outcomes.Methods Group A (n =269) underwent laparoscopic bilateral salpingectomy before ET while group B (n =178) had laparoscopic bilateral tubal salpingostomy for hydrosalpinx.And the pregnancy outcomes of ET were evaluated.Results The implantation,pregnancy,abortion,ectopic pregnancy and live birth rates were similar in 2 groups (P > 0.05).The interstitial pregnancy rate was 10.27% after bilateral salpingectomy.The clinical pregnancy rate increased while the interstitial pregnancy rate decreased when the intervals between salpingectomy and ET were prolonged.But there was no statistical significance (P > 0.05).Conclusion Laparoscopic tubal salpingostomy is as effective as salpingectomy for hydrosalpinx before ET.The interstitial pregnancy rate increases after laparoscopic salpingectomy.The interval between salpingectomy and ET should be appropriately scheduled.
More- 浏览:300
- 被引:22
- 下载:128
相似文献
- 中文期刊
- 外文期刊
- 学位论文
- 会议论文