子宫腺肌病对体外受精-胚胎移植临床结局的影响

发布时间：2018-02-21 23:57

本文关键词： 子宫腺肌病体外受精/卵胞浆内单精子注射-胚胎移植临床结局　出处：《南方医科大学学报》2015年02期 　论文类型：期刊论文

【摘要】：目的探讨子宫腺肌病对不孕患者体外受精-胚胎移植(IVF/ICSI-ET)临床结局的影响及其可能的原因。方法回顾性分析南方医院经阴道超声诊断为子宫腺肌病患者61个IVF/ICSI周期作为研究组,对照组为164例单纯输卵管性不孕患者。对两组的一般情况、控制性促排卵过程中的卵巢反应性、胚胎着床率、临床妊娠率、早期流产率、活产率等进行分析。结果研究组的新鲜周期胚胎着床率、临床妊娠率、活产率均显著低于对照组(P0.05),早期流产率显著高于对照组(P0.05)。研究组中,与Gn RHa降调节的长方案相比,Gn RH拮抗剂方案对临床妊娠率、早期流产率均有不利影响(25.0%vs 45.0%,P=0.184;66.7%vs27.8%,P=0.247),但无统计学差异,而活产率显著低于长方案组患者(0%vs 30.8%,P=0.025)。结论子宫腺肌病降低不孕患者IVF/ICSI-ET的胚胎着床率、临床妊娠率、活产率,且增加流产率,Gn RH拮抗剂方案对子宫腺肌病患者IVF/ICSI-ET的临床结局有负面影响,Gn RHa长方案能够增加IVF/ICSI-ET的临床妊娠率、降低流产率。
[Abstract]:Objective to investigate the effect of adenomyosis on the clinical outcome of IVF / ICSI-ETT in infertile patients and its possible causes. Methods 61 IVF/ICSI cycles of patients with adenomyosis diagnosed by transvaginal ultrasound in Southern Hospital were analyzed retrospectively. The control group consisted of 164 patients with simple oviduct infertility. The ovarian reactivity, embryo implantation rate, clinical pregnancy rate and early abortion rate during controlled ovulation induction were observed in the two groups. Results the implantation rate, clinical pregnancy rate and live birth rate of fresh cycle embryos in the study group were significantly lower than those in the control group (P 0.05), and the early abortion rate was significantly higher than that in the control group (P 0.05). Compared with the long regimen of Gn RHa downregulation, the Gn RH antagonist regimen had adverse effects on the clinical pregnancy rate and early abortion rate, but there was no statistical difference in the clinical pregnancy rate and the early abortion rate between 25.0 and 45.0% (P 0.1848 vs 66.7 vs 27.8 vs 0.247), but there was no significant difference between the two groups in clinical pregnancy rate and early abortion rate, but there was no significant difference in the clinical pregnancy rate and the early abortion rate between the two groups. The live delivery rate was significantly lower than that in the long regimen group (P < 0.05). Conclusion the implantation rate, clinical pregnancy rate and live delivery rate of IVF/ICSI-ET in patients with adenomyosis were significantly lower than those in the long regimen group. Increasing abortion rate and Gn RH antagonist regimen had negative effects on the clinical outcome of IVF/ICSI-ET in patients with adenomyosis. The long regimen of Gn RHa could increase the clinical pregnancy rate of IVF/ICSI-ET and decrease the abortion rate.
【作者单位】：南方医科大学南方医院妇产科生殖医学中心;
【基金】：国家自然科学基金(81170574) 南方医院高层次课题(G201206)~~
【分类号】：R714.8

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