剖宫产手术史对体外受精-胚胎移植患者临床结局的影响

发布时间：2018-02-14 16:42

本文关键词： 剖宫产体外受精-胚胎移植(IVF-ET) 妊娠率并发症　出处：《中华生殖与避孕杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的探讨剖宫产手术史对体外受精-胚胎移植(IVF-ET)患者临床结局的影响。方法回顾性分析2013年1月—2015年12月行IVF-ET且有剖宫产手术史的144例患者的助孕情况、妊娠及分娩结局,对照组为同期行IVF-ET且既往仅有阴道分娩史的166例患者。结果与对照组比较,剖宫产史组基础卵泡刺激素水平(b FSH)、人绒毛膜促性腺激素(h CG)注射日雌二醇(E2)水平、子宫内膜厚度、促性腺激素(Gn)用量、G n刺激时间,获卵率、受精率、卵裂率、优质胚胎率、胚胎移植数、多胎妊娠率、流产率、异位妊娠率差异均无统计学意义(P0.05);但剖宫产手术史组胚胎移植困难比例(6.25%)高于阴道分娩史组(0.00%),胚胎种植率(24.01%)及临床妊娠率(40.28%)明显低于阴道分娩史组(分别为34.98%和54.82%),差异均有统计学意义(P0.05);剖宫产史组双胎妊娠者较对照组双胎妊娠发生前置胎盘、产后出血比例增加(P0.05);无论是剖宫产手术史组还是阴道分娩史组,双胎分娩较单胎分娩新生儿出生孕周、体质量明显降低(P0.01)。结论剖宫产手术史可能降低IVF-ET患者的胚胎种植率和临床妊娠率,增加胚胎移植难度。对疤痕子宫妇女应严格控制移植胚胎数目,妊娠后加强孕期监管。
[Abstract]:Objective to investigate the influence of cesarean section history on the clinical outcome of IVF-ETpatients undergoing in vitro fertilization and embryo transfer (IVF-ETS). Methods the pregnancy aid, pregnancy and delivery outcome of 144 patients who underwent IVF-ET from January 2013 to December 2015 and had a history of cesarean section were analyzed retrospectively. Results compared with the control group, the basal follicle stimulating hormone level and human chorionic gonadotropin (hCG) were injected with estradiol E _ 2 (E _ 2) and endometrial thickness, compared with the control group. Gonadotropin Gnn was used to stimulate time, oocyte acquisition rate, fertilization rate, cleavage rate, high quality embryo rate, number of embryo transfer, multiple pregnancy rate, abortion rate, There was no significant difference in ectopic pregnancy rate (P 0.05), but the proportion of difficult embryo transfer in the history of cesarean section group (6.25%) was higher than that in the vaginal delivery history group (0.000%), the embryo implantation rate (24.01%) and the clinical pregnancy rate (40.28%) were significantly lower than those in the vaginal delivery history group (34.98% vs 40.28) (P < 0.05). 54.82 cases had significant difference (P 0.05), and the cases with history of cesarean section had placenta previa in comparison with those in the control group. The proportion of postpartum hemorrhage increased (P 0.05), whether in the group of history of cesarean section or the group of history of vaginal delivery, the gestational weeks of twins were higher than those of newborns with single birth. Conclusion the history of cesarean section may decrease the embryo implantation rate and clinical pregnancy rate in IVF-ET patients and increase the difficulty of embryo transfer.
【作者单位】：武汉大学人民医院生殖医学中心;
【分类号】：R714.8

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