Hysteroscopy prior to repeat embryo transfer may improve pregnancy outcomes for asymptomatic women with repeated implantation failure
Hysteroscopy prior to repeat embryo transfer may improve pregnancy outcomes for asymptomatic women with repeated implantation failure
复制标题
重复胚胎移植前进行宫腔镜检查可能会改善反复植入失败的无症状女性的妊娠结局
DOI：
10.1111/jog.12773
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发表时间：
2015-10-01
影响因子：
1.6
通讯作者：
Zhao, Xiaoming
中科院分区：
文献类型：
--
作者：
Gao, Minzhi;Sun, Yun;Zhao, Xiaoming
目的探讨宫腔镜术在无症状重复着床失败(RIF)患者重复胚胎移植前宫内异常发现及改善妊娠结局中的作用。材料与方法对672例无症状重复着床失败妇女进行前瞻性队列研究。结果HS组宫内异常发生率为37.13%。最常见的异常包括子宫内膜息肉或息肉样子宫内膜、子宫内膜增生症和宫腔粘连。HS组的临床妊娠率和种植率分别为41.92%和23.82%，显著高于非HS组的32.25%和18.60%。早期流产、宫外孕、晚期流产和活产率差异无统计学意义。HS组和HS组的临床妊娠率和种植率均显著高于非HS组，但组间差异无统计学意义。结论HS可改善宫内异常或无异常的妊娠结局。RIF妇女在重复胚胎移植前可常规进行HS。
AimThe aim of this study was to evaluate the efficacy of hysteroscopy (HS) in detecting intrauterine abnormalities prior to repeat embryo transfer and improving pregnancy outcomes in asymptomatic women with repeated implantation failure (RIF).Material and MethodsA prospective cohort study was conducted involving 672 asymptomatic RIF women from a Chinese university hospital. Pregnancy outcomes between the HS (subdivided into patients with and without intrauterine abnormalities) and non-HS groups were compared.ResultsThe incidence of intrauterine abnormalities in the HS group was 37.13%. The most common abnormalities included endometrial polyps or polypoid endometrium, endometrial hyperplasia and intrauterine adhesions. Clinical pregnancy and implantation rates in the HS group were significantly higher than in the non-HS group (41.92% vs 32.25%; 23.82% vs 18.60%, respectively). There were no significant differences in early abortion, ectopic pregnancy, late abortion and live birth rates. The clinical pregnancy and implantation rates in both HS subgroups were significantly higher when compared to the non-HS group, whereas there were no significant differences between the subgroups.ConclusionHS improved pregnancy outcomes in women with or without intrauterine abnormalities. HS may be routinely performed before repeat embryo transfer in RIF women.