CAJ | 학술논문

目的探讨输卵管切除术和输卵管造口术对体外受精-胚胎移植(IVF-ET)妊娠结局的影响.方法将2012年1月至2013年12月因输卵管因素不孕在浙江大学附属邵逸夫医院生殖医学中心行胚胎移植的447例患者分成两组:A组,腹腔镜下双侧输卵管切除术后269例;B组,腹腔镜下双侧输卵管造口术后178例.比较两组间鲜胚及冻胚周期的临床妊娠率、胚胎种植率、早期流产率、异位妊娠率及活产率.结果两组间鲜胚及冻胚周期的移植胚胎数、移植优胚数、着床率、临床妊娠率、早期流产率、异位妊娠率以及活产及继续妊娠率比较,差异均无统计学意义(均P ＞0.05).双侧输卵管切除术后输卵管间质部妊娠率为10.27％(15/146).随着术后胚胎移植间隔时间的延长,输卵管切除术后临床妊娠率逐渐升高,输卵管间质部妊娠率逐渐下降,但差异无统计学意义(P＞0.05).结论作为输卵管病变的IVF前预处理,输卵管造口术与输卵管切除术在改善胚胎移植结局方面同样有效.输卵管切除后输卵管间质部妊娠发生率升高,输卵管切除后胚胎移植应与手术间隔适当时间.
목적 탐토수란관절제술화수란관조구술대체외수정-배태이식(IVF-ET)임신결국적영향.방법 장2012년1월지2013년12월인수란관인소불잉재절강대학부속소일부의원생식의학중심행배태이식적447례환자분성량조:A조,복강경하쌍측수란관절제술후269례;B조,복강경하쌍측수란관조구술후178례.비교량조간선배급동배주기적림상임신솔、배태충식솔、조기유산솔、이위임신솔급활산솔.결과 량조간선배급동배주기적이식배태수、이식우배수、착상솔、림상임신솔、조기유산솔、이위임신솔이급활산급계속임신솔비교,차이균무통계학의의(균P ＞0.05).쌍측수란관절제술후수란관간질부임신솔위10.27％(15/146).수착술후배태이식간격시간적연장,수란관절제술후림상임신솔축점승고,수란관간질부임신솔축점하강,단차이무통계학의의(P＞0.05).결론 작위수란관병변적IVF전예처리,수란관조구술여수란관절제술재개선배태이식결국방면동양유효.수란관절제후수란관간질부임신발생솔승고,수란관절제후배태이식응여수술간격괄당시간.
Objective To explore the effects of different laparoscopic procedures before embryo transfer (ET) for hydrosalpinx on pregnancy outcomes.Methods Group A (n =269) underwent laparoscopic bilateral salpingectomy before ET while group B (n =178) had laparoscopic bilateral tubal salpingostomy for hydrosalpinx.And the pregnancy outcomes of ET were evaluated.Results The implantation,pregnancy,abortion,ectopic pregnancy and live birth rates were similar in 2 groups (P ＞ 0.05).The interstitial pregnancy rate was 10.27％ after bilateral salpingectomy.The clinical pregnancy rate increased while the interstitial pregnancy rate decreased when the intervals between salpingectomy and ET were prolonged.But there was no statistical significance (P ＞ 0.05).Conclusion Laparoscopic tubal salpingostomy is as effective as salpingectomy for hydrosalpinx before ET.The interstitial pregnancy rate increases after laparoscopic salpingectomy.The interval between salpingectomy and ET should be appropriately scheduled.