Endometrial polyps and their implication in the pregnancy rates of patients undergoing intrauterine insemination:: a prospective, randomized study
Endometrial polyps and their implication in the pregnancy rates of patients undergoing intrauterine insemination:: a prospective, randomized study
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DOI：
10.1093/humrep/deh822
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发表时间：
2005-06-01
影响因子：
6.1
通讯作者：
Engels, V
中科院分区：
文献类型：
--
作者：
Pérez-Medina, T;Bajo-Arenas, J;Engels, V
背景：我们的目的是确定宫腔内人工授精（IUI）前宫腔镜息肉切除术是否比不干预获得更好的妊娠结局。方法：选取某大学三级医院不孕科超声诊断子宫内膜息肉（EP）行人工授精的215例不孕症妇女，采用不透明包膜技术随机分为两组预处理，随机数字表分配。研究组行宫腔镜息肉切除术。对照组行诊断性宫腔镜检查和息肉活检。结果：通过列联表和生命表分析，比较两组在4个IUI周期后的总妊娠率和成功时间。总共有93人怀孕，其中64人在研究组，29人在对照组。研究组的妇女在息肉切除术后怀孕的可能性更大，相对危险度为2.1（95%可信区间为1.5-2.9）。研究组中65%的病例是在第一次人工授精前怀孕的。结论：提示宫内节育术前宫腔镜息肉切除术是有效措施。
BACKGROUND: It was our intention to determine whether hysteroscopic polypectomy before intrauterine insemination (IUI) achieved better pregnancy outcomes than no intervention. METHODS: A total of 215 infertile women from the infertility unit of a university tertiary hospital with ultrasonographically diagnosed endometrial polyps (EP) undergoing IUI were randomly allocated to one of two pretreatment groups using an opaque envelope technique with assignment determined by a random number table. Hysteroscopic polypectomy was performed in the study group. Diagnostic hysteroscopy and polyp biopsy was performed in the control group. RESULTS: Total pregnancy rates and time for success in both groups after four IUI cycles were compared by means of contingency tables and life-table analysis. A total of 93 pregnancies occurred, 64 in the study group and 29 in the control group. Women in the study group had a better possibility of becoming pregnant after polypectomy, with a relative risk of 2.1 (95% confidence interval 1.5-2.9). Pregnancies in the study group were obtained before the first IUI in 65% of cases. CONCLUSIONS: These data suggest that hysteroscopic polypectomy before IUI is an effective measure.