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体外受精——胚胎移植前输卵管积水处理方法探讨

The Approach of the Treatmeat before in Vitro Fertilization and Embryo Transfer on Patients with Hydrosalpinx

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【作者】 邹红艳邹湘丽罗群芳钱卫平张敏

【Author】 ZOU Hong-Yan, ZOU Xiang-Li, LUO Qun-Fang et al. Reproductive Medical Center of Luo - Hu Hospital ShenZhen, GuangDong 518000, China

【机构】 深圳市罗湖区人民医院生殖医学中心深圳市罗湖区人民医院生殖医学中心 518000518000518000

【摘要】 目的:探讨体外受精-胚胎移植(IVF-ET)前输卵管积水处理方法。方法:回顾性分析因女性输卵管因素不孕 行IVF-ET治疗的497周期资料,按处理方法不同分为4组,A组:输卵管积水未处理直接行IVF-ET 43周期;B组:在IVF- ET前腹腔镜切除积水输卵管29周期;C组超排卵前及取卵时均抽吸输卵管积水65周期;D组:输卵管阻塞,无积水360周期。结 果:A、B、C、D组IVF-ET的种植率分别是10.1%、18.3%、19.2%、19.5%,临床妊娠率分别为20.9%、37.9%、38.5 %、45.0%,A组的种植率及临床妊娠率较其他组明显降低;B组促排卵用药量,获卵数较其他组显著降低,异位妊娠发生率显 著降低,有统计学意义。结论:切除积水之输卵管及抽吸输卵管积水均可改善IVF-ET结局。前者异位妊娠发生率降低,促卵药 量增加,获卵减少;后者简单、安全、损伤小,应结合患者具体情况,做出最佳选择。

【Abstract】 Objective: To evaluate the different treatments before in Vitro Fertilization and Embryo Transfer (IVF-ET) in patients with hydrosalpinx. Methods: Data of 497 cycles with tubal factor infertility of IVF-ET . Patients were divided into four groups according to different treatments options of hydrosalpinx: Group A: 43 cycles without treatment of hydrosalpinx before IVF -ET; Group B : 29 cycles with salpingostomy performed under Laparoscope before IVF-ET; Group C: 65 cycles take out the tubal fluid before superovulation and follicle retrieved ; Group D: 360 cycles with Fallopian tube obstruction but no hydrosalpinx. Results: IVF-ET implantation rate was 10. 1%,18. 3%,19. 2% and 19. 5% respectively, and pregnancy rate was 20. 9%,37. 9%, 38. 5% and 45. 0% respectively . implantation rate and pregnancy rate in group A were significantly lower than that in the other three groups . The medicine dose and retrieved follicles of groupB were lower than that of the other groups, but the ectopic pregnancy rate of group B was significantly lower than that of other groups. Conclusion: Removal of hydrosalpinx by salpingectomy and take out tubal fluid both can improve the result of IVF-ET . the former, s ectopic pregnancy rate is lower , the medicine dose is higher , the retrieved follicles are less ; the latter is more simply , safety and has small chance to be injured . different treatment should be choosed to different patients.

  • 【文献出处】 中国妇幼保健 ,Maternal and Child Health Care of China , 编辑部邮箱 ,2004年17期
  • 【分类号】R711.6
  • 【被引频次】2
  • 【下载频次】93
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