Effect of treatment of intrauterine pathologies with office hysteroscopy in patients with recurrent lVF failure
Effect of treatment of intrauterine pathologies with office hysteroscopy in patients with recurrent lVF failure
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DOI：
10.1016/s1472-6483(10)61108-x
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发表时间：
2004-05-01
影响因子：
4
通讯作者：
Gurgan, T
中科院分区：
文献类型：
--
作者：
Demirol, A;Gurgan, T
本研究旨在评价宫腔镜诊断和治疗宫内病变对反复体外受精和胚胎移植失败患者的妊娠结局是否有价值。421例经历两次或两次以上ivf -胚胎移植失败的患者被前瞻性地随机分为两组。组1 （n = 211）未行宫腔镜检查，组11 （n = 210）行宫腔镜检查。宫腔镜检查结果正常的患者纳入IIa组（n = 154），宫腔镜检查结果异常的患者纳入IIb组（n = 56）。宫内病变诊断是在办公室的程序进行手术。II组56例（26%）患者出现宫内病变，同时进行治疗。各组患者平均取卵数、受精率、胚胎移植数及妊娠早期流产率均无差异。I、IIa、IIb组临床妊娠率分别为21.6%、32.5%、30.4%。I组和IIa组患者的临床妊娠率分别为21.6%和32.5%,P = 0.044； I组和IIb组患者的临床妊娠率分别为21.6%和30.4%,P = 0.044。IIa组和IIb组患者临床妊娠率差异无统计学意义。子宫输卵管造影正常但反复发生ivf -胚胎移植失败的患者应在开始ivf -胚胎移植周期前进行评估，以提高临床妊娠率。
The study was conducted to evaluate if the diagnosis and treatment of intrauterine lesions with office hysteroscopy is of value in improving the pregnancy outcome in patients with recurrent in-vitro fertilization and embryo transfer failure. Four hundred and twenty-one patients who had undergone two or more failed IVF-embryo transfer cycles were prospectively randomized into two groups. Group I (n = 211) did not have office hysteroscopic evaluation, Group 11 (n = 2 10) had office hysteroscopy. The patients who had normal hysteroscopic findings were included in Group IIa (n = 154) and patients who had abnormal hysteroscopic findings were included in Group IIb (n = 56). Intrauterine lesions diagnosed were operated during the office procedure. Fifty-six (26%) patients in Group II had intrauterine pathologies and the treatment was performed at the same time. No difference existed in the mean number of oocyte retrieved, fertilization rate, number of embryos transferred or first trimester abortion rates among the patients in groups. Clinical pregnancy rates in Group I, Group IIa and Group IIb were 21.6%, 32.5% and 30.4% respectively. There was a significant difference in the clinical pregnancy rates between patients in Group I and Group IIa (21.6% and 32.5%, P = 0.044, respectively) and Group I and Group IIb (21.6% and 30.4%, P = 0.044, respectively). There was no significant difference in the clinical pregnancy rate of patients in Groups IIa and IIb. Patients with normal hysterosalpingography but recurrent IVF-embryo transfer failure should be evaluated prior to commencing IVF-embryo transfer cycle to improve the clinical pregnancy rate.