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目的:探讨胚胎移植周期子宫内膜病理组织学对体外受精-胚胎移植(IVF-ET)妊娠结局的影响。方法:月经周期的第5～6天因B超示子宫内膜厚度≥7mm或回声不均匀的IVF-ET助孕治疗的患者77例纳入研究对象,于月经周期的第5～6天搔刮修整子宫内膜,刮出的内膜做病理组织学检查。结果:77例中送病理检查者49例,因刮出组织少无法送病检者28例。病理检查示子宫内膜息肉17例,内膜发育不同步13例,子宫内膜增殖期12例,简单型增生过长2例,子宫内膜炎症3例,2例复杂型增生过长放弃新鲜胚胎移植,其余均行胚胎移植。子宫内膜息肉妊娠率41.18%,内膜发育不同步妊娠率46.15%,子宫内膜增殖期妊娠率58.33%,简单型增生过长妊娠率50.00%,3例子宫内膜炎无1例妊娠。未送病理检查者妊娠率17.86%。结论:除子宫内膜炎外,子宫内膜的不同病理组织学改变不影响临床妊娠率;子宫内膜未得到修整者妊娠率显著下降。
Objective: To investigate the effect of embryo transfer endometrial histopathology on the pregnancy outcome of in vitro fertilization-embryo transfer (IVF-ET). Methods: From the 5th to 6th days of the menstrual cycle, 77 patients with IVF-ET-assisted pregnancy who had endometrial thickness ≥7 mm or echogenicity by B ultrasound were included in the study. Scratch was performed on the 5th to 6th day of the menstrual cycle Dressing the endometrium, scraping the endometrium to do histopathological examination. Results: Among the 77 cases, 49 cases were sent pathological examination, 28 cases were not sent to the pathological examination because of the scraped tissue. Pathological examination showed 17 cases of endometrial polyps, 13 cases of endometrial dysplasia, 12 cases of endometrial hyperplasia, 2 cases of simple hyperplasia, 3 cases of endometrial inflammation, 2 cases of complex hyperplasia to give up fresh Embryo transfer, the rest were embryo transfer. Endometrial polyps pregnant rate of 41.18%, intima development asynchronous pregnancy rate of 46.15%, endometrial proliferative pregnancy rate of 58.33%, simple hyperplasia pregnancy rate of 50.00%, 3 cases of endometritis without pregnancy in 1 case. The pregnancy rate of 17.86% did not send pathological examination. Conclusion: In addition to endometritis, endometrial histopathological changes do not affect the clinical pregnancy rate; endometrial uncoated pregnancy rate decreased significantly.