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目的评价体外受精胚胎移植(INVITROFERTILIZATIONEMBRYOTRANSFERRED,IVF-ET)失败患者的宫腔因素及宫腔镜的诊治意义。方法对52例体外受精(IVF)失败者进行宫腔镜检查及治疗后,行IVF-ET(36例),并与40例IVF失败而未做宫腔镜检查者比较再次IVF-ET的临床妊娠率。结果宫腔镜检查发现宫腔异常率为36.5%(19/52),其中子宫内膜息肉68.4%(13/19),子宫内膜息肉样增生10.5%(2/19),子宫内膜炎症10.5%(2/19),子宫内膜复合增生5.3%(1/19),宫腔轻度粘连5.3%(1/19)。52例中36例进行再次IVF-ET,根据宫腔镜结果分为宫腔正常组23例及异常组13例。再次IVF-ET的临床妊娠率宫腔正常组和异常组均高于对照组(分别为30.4%、38.5%、20.0%),但无显著性差异。结论IVF-ET失败患者宫腔镜检查阳性率高,宫腔镜是寻找IVF-ET失败原因很有价值的检查手段,建议对反复IVF-ET失败者常规应用。
Objective To evaluate the uterine factors and the significance of hysteroscopy in the failure of in vitro fertilization embryo transfer (IVF-ET). Methods Fifty-two IVF losers were subjected to hysteroscopy and treatment. IVF-ET (36 cases) was performed and compared with 40 cases of failed IVF-IV without hysteroscopy Pregnancy rate. Results Hysteroscopy showed abnormal uterine cavity rate was 36.5% (19/52), of which endometrial polyps 68.4% (13/19), endometrial polypoid hyperplasia 10.5% (2/19), endometrial inflammation 10.5% (2/19), endometrial hyperplasia 5.3% (1/19), uterine cavity slight adhesions 5.3% (1/19). Thirty-six patients in 52 cases underwent IVF-ET again. According to the results of hysteroscopy, they were divided into 23 cases of normal uterine cavity group and 13 cases of abnormal group. The IVF-ET clinical pregnancy rate of the uterine cavity normal group and abnormal group were higher than the control group (30.4%, 38.5%, 20.0%), but no significant difference. Conclusions Hysteroscopy in patients with failed IVF-ET has a high positive rate of hysteroscopy. Hysteroscopy is a valuable means of finding the cause of failure of IVF-ET. It is recommended to routinely apply IVF-ET to losers.