摘要
目的探讨子宫腺肌病对不孕患者体外受精-胚胎移植(IVF/ICSI-ET)临床结局的影响及其可能的原因。方法回顾性分析南方医院经阴道超声诊断为子宫腺肌病患者61个IVF/ICSI周期作为研究组,对照组为164例单纯输卵管性不孕患者。对两组的一般情况、控制性促排卵过程中的卵巢反应性、胚胎着床率、临床妊娠率、早期流产率、活产率等进行分析。结果研究组的新鲜周期胚胎着床率、临床妊娠率、活产率均显著低于对照组(P<0.05),早期流产率显著高于对照组(P<0.05)。研究组中,与Gn RHa降调节的长方案相比,Gn RH拮抗剂方案对临床妊娠率、早期流产率均有不利影响(25.0%vs 45.0%,P=0.184;66.7%vs27.8%,P=0.247),但无统计学差异,而活产率显著低于长方案组患者(0%vs 30.8%,P=0.025)。结论子宫腺肌病降低不孕患者IVF/ICSI-ET的胚胎着床率、临床妊娠率、活产率,且增加流产率,Gn RH拮抗剂方案对子宫腺肌病患者IVF/ICSI-ET的临床结局有负面影响,Gn RHa长方案能够增加IVF/ICSI-ET的临床妊娠率、降低流产率。
Objective To explore the effects of uterine adenomyosis on the clinical outcomes of infertility patients treated with in vitro fertilization/intracytoplasmic sperm injection- embryo transfer（IVF/ICSI- ET）. Methods A retrospective study was conducted of 61 IVF/ICSI-ET cycles as the study group, diagnosed with uterine adenomyosis by transvaginal ultrasound, and164 IVF/ICSI-ET cycles of patients with tubal infertility as the control group. The baseline characteristics, ovary response and clinical outcomes were compared between the two groups. Results The implantation rate, clinical pregnancy rate and live birth rate decreased significantly in the study group（P〈0.05）, and early abortion rate increased significantly（P〈0.05）. For patients with adenomyosis, Gn RH- antagonist cycles tended to decrease clinical pregnancy rate and increase abortion rate（25.0% vs45.0%, P=0.184; 66.7% vs 27.8%, P=0.247）, and significantly decrease live birth rate（0% vs 30.8%, P=0.025）, compared with Gn RHa agonist cycles. Conclusion Uterine adenomyosis decreases implantation rate, clinical pregnancy rate and birth rate,and increases abortion rate significantly in patients with IVF/ICSI- ET. Gn RH- antagonist cycles have adverse effects on the outcomes of adenomyosis; Gn RH agonist long protocol cycles may increase clinical pregnancy rate and decrease abortion rate.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2015年第2期248-251,共4页
Journal of Southern Medical University
基金
国家自然科学基金(81170574)
南方医院高层次课题(G201206)~~
关键词
子宫腺肌病
体外受精/卵胞浆内单精子注射-胚胎移植
临床结局
uterine adenomyosis
in vitro fertilization/intracytoplasmic sperm injection-embryo transfer（IVF/ICSI-ET）
clinical outcomes
