不孕症合并瘢痕子宫患者胚胎解冻移植周期妊娠结局分析

发布时间：2018-11-03 10:47

【摘要】：目的探讨不孕症合并瘢痕子宫(剖宫产术后)患者行胚胎解冻移植(F-ET)后妊娠结局及剖宫产后子宫切口憩室(PCSD)对F-ET妊娠结局的影响。方法回顾性分析行F-ET助孕的瘢痕子宫(剖宫产术后)309个周期(瘢痕子宫组),按年龄匹配,随机选取同期行F-ET的因输卵管因素不孕非瘢痕子宫309个周期(对照组),PCSD组(n=67),无PCSD(NPCSD)组(n=242),分别比较3组胚胎种植及妊娠结局等。结果单胚胎移植(SET)周期3组种植率及临床妊娠率差异无统计学意义。双胚胎移植(DET)PCSD组胚胎种植率及临床妊娠率均低于NPCSD组及对照组,差异有统计学意义(P0.05)。NPCSD组及对照组在DET及三胚胎种植率、临床妊娠率均差异无统计学意义。3组在不同的移植胚胎数目时胚胎种植率、临床妊娠率均差异无统计学意义。3组患者SET后均无多胎妊娠发生,NPCSD组及对照组患者移植3枚胚胎时多胎妊娠率较DBT时增高,但差异无统计学意义。3组患者流产率及双胎活产率均差异无统计学意义。PCSD组患者报婴回家率低于其他两组(P0.05)。结论 SET可在不降低胚胎种植率的前提下有效降低多胎妊娠率。PCSD影响胚胎种植率、临床妊娠率、报婴回家率,但不影响流产率。
[Abstract]:Objective to investigate the pregnancy outcome after embryo thawing transfer (F-ET) in infertile women with scar uterus (after cesarean section) and the effect of (PCSD) on the pregnancy outcome of F-ET after cesarean section. Methods A retrospective analysis of 309 cycles of scar uterus (cicatricial uterus group) undergoing F-ET assisted pregnancy (cesarean section group) was performed. According to age matching, 309 cycles of sterility due to fallopian tube factors were randomly selected (control group). The embryo implantation and pregnancy outcome were compared in PCSD group (n = 67) and no PCSD (NPCSD) group (n = 242). Results there was no significant difference in implantation rate and clinical pregnancy rate among the three groups in (SET) cycle of single embryo transfer. The embryo implantation rate and clinical pregnancy rate in (DET) PCSD group were lower than those in NPCSD group and control group, the difference was statistically significant (P0.05). There was no significant difference in the clinical pregnancy rate between the three groups. There was no significant difference in the implantation rate and the clinical pregnancy rate among the three groups. There was no multiple pregnancy after SET in all the three groups. The pregnancy rate of 3 embryos in NPCSD group and control group was higher than that in DBT group. But the difference was not statistically significant. There was no significant difference in abortion rate and twin live birth rate among the three groups. The rate of home delivery in PCSD group was lower than that in the other two groups (P0.05). Conclusion SET can effectively reduce the rate of multiple pregnancy without reducing the rate of embryo implantation. PCSD can affect the rate of embryo implantation, clinical pregnancy and the rate of home delivery, but it does not affect the rate of abortion.
【作者单位】：安徽医科大学第一附属医院妇产科生殖医学中心;
【基金】：卫生行业科研专项项目(编号:201402004)
【分类号】：R714.8

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