CAJ | 학술논문

目的探讨子官内膜搔刮对临床妊娠的影响.方法选择2007年1月至2007年12月间的759例行体外受精-胚胎移植(IVF-ET)新鲜周期助孕的不孕患者,随机选择其中68例患者为治疗组(进行子宫内膜搔刮),在IVF前周期月经4～5 d对子宫内膜行搔刮术;其余691例为对照组(未行子宫内膜搔刮).两组患者的年龄、不育年限、不育原因、促性腺激素(Gn)天数、Gn用量、获卵数、移植胚胎数、受精率差异无统计学意义;比较两组患者的临床妊娠率;将两组患者再分为原发组、继发组,先比较诊刮组和非诊刮组内原发、继发不孕患者的妊娠结局,再分别比较两组间原发、继发不孕的妊娠结局;将两组患者再分为第1周期、≥第2周期组,先分别比较诊刮组和非诊刮组内第1周期、≥第2周期组不孕患者的妊娠结局、再分别比较两组第1周期、≥第2周期组的妊娠结局.结果两组比较,临床妊娠率、流产及宫外孕率差异无统计学患义;两组间、两组内原发、继发组临床妊娠率、流产及官外孕率差异无统计学意义;治疗组、对照组第1周期临床妊娠率分别为38.89%和37.16%,差异无统计学意义,≥第2周期临床妊娠率分别为53.13%、34.33%,差异有统计学意义.结论子官内膜搔刮从一定程度上可提高子宫内膜的容受性,尤其对于IVF反复失败患者子宫内膜搔刮显著提高再次助孕周期临床妊娠率.
목적 탐토자관내막소괄대림상임신적영향.방법 선택2007년1월지2007년12월간적759례행체외수정-배태이식(IVF-ET)신선주기조잉적불잉환자,수궤선택기중68례환자위치료조(진행자궁내막소괄),재IVF전주기월경4～5 d대자궁내막행소괄술;기여691례위대조조(미행자궁내막소괄).량조환자적년령、불육년한、불육원인、촉성선격소(Gn)천수、Gn용량、획란수、이식배태수、수정솔차이무통계학의의;비교량조환자적림상임신솔;장량조환자재분위원발조、계발조,선비교진괄조화비진괄조내원발、계발불잉환자적임신결국,재분별비교량조간원발、계발불잉적임신결국;장량조환자재분위제1주기、≥제2주기조,선분별비교진괄조화비진괄조내제1주기、≥제2주기조불잉환자적임신결국、재분별비교량조제1주기、≥제2주기조적임신결국.결과 량조비교,림상임신솔、유산급궁외잉솔차이무통계학환의;량조간、량조내원발、계발조림상임신솔、유산급관외잉솔차이무통계학의의;치료조、대조조제1주기림상임신솔분별위38.89%화37.16%,차이무통계학의의,≥제2주기림상임신솔분별위53.13%、34.33%,차이유통계학의의.결론 자관내막소괄종일정정도상가제고자궁내막적용수성,우기대우IVF반복실패환자자궁내막소괄현저제고재차조잉주기림상임신솔.
Objective To analyze the effect of endometrial stimulation on the pregnancy outcome of patients undergoing in vitro fertilization-embryo transfer (IVF-ET).Methods A total of 759 subjects were treated by fresh IVF at our hospital in 2007.Sixty-eight subjects received endometrial stimulation at Days 4-5 of menstruation before IVF while other 691 were controls without treatment.No significant difference was found between two groups in terms of duration and cause for infertility,day and dosage of Gn ,number of retrieved oocytes and transferred embryos and fertilization rate.The clinical pregnancy rate of two groups were analyzed.Firstly the clinical outcomes for the patients of primary or secondary infertility were compared in treatment and control groups respectively.Then the clinical outcomes of the patients in first cycle and later cycles were compared in treatment and control groups respectively.Results There were no significant differences in clinical pregnancy rate and incidence of abortion and ectopic pregnancy.For first cyclers,the clinical pregnancy rate showed no significant difference between two groups (38.89% vs 37.16%).But for later cyclers,the clinical pregnancy rate was higher in the treatment group than that in the control group (53.13% vs 34.33%).Conclusion Endometrial stimulation may improve endometrial receptivity to some extent.And it can boost the clinical pregnancy rate for those patients with a repeated implantation failure.