腹部超声引导下胚胎移植位置对IVFET结局的影响.docVIP

腹部超声引导下胚胎移植位置对IVFET结局的影响 作者：曲庆兰 郝翠芳 张宁 包洪初 【摘要】 　　目的 评价腹部超声引导下胚胎移植位置对体外受精胚胎移植（IVFET）结局的影响。方法 回顾分析在本中心行IVFET病人586例610个移植周期的资料，比较胚胎移植位置和临床结局之间的关系。结果根据B超所测量移植后含有胚胎的培养液强回声距宫底的距离分为4组,各组间年龄、获卵数、移植优质胚胎数、流产率以及异位妊娠率比较，差异均无显著意义（Pgt;0.05）；gt;2.0 cm组的临床妊娠率及胚胎种植率显著高于lt;1.0 cm组，差异有显著性（χ2=102.4、123.6， Plt;0.05）。结论 腹部超声引导下将胚胎移植于距宫底2.0 cm处或宫腔中下1/3处临床妊娠率和胚胎种植率较高。 【关键词】 胚胎移植 妊娠率 种植率 超声检查 　　［ABSTRACT］ Objective To investigate the effect of embryo location after ultrosuondguided transfer on the outcomes of in vitro fertilization and embryo transfer (IVFET). Methods The data of 586 patients undergoing IVFET (including intracytoplasmic sperm injection) therapy for 610 cycles were analyzed retrospectively. All embryo transfer procedures were guided by transabdominal ultrasonography and the distance between transfer bubble and transfer catheter tip or the fundus was measured. Results All the 610 cycles were divided into four groups based on the distance between embryo location and the fundus. There were no statistical differences in age, number of oocyte, number of embryo which were transferred, abortion rate and ectopic pregnancy rate among the four groups. The clinical pragnancy rate and embryo implantation rate were statistically higher in gt;2.0 cm group than in lt;1.0 cm group (χ2=102.4,123.6；Plt;0.05). Conclusion The pregnancy and implantation rates were higher when the distance between the location of embryo and the fundus was more than 2.0 cm or the embryo was transfered at the lower 1/3 of endometrial cavity in IVFET cycles. 　　［KEY WORDS］ Embryo transfer; Pregnancy rate; Implantation rate; Ultrasonography 　　体外受精胚胎移植（IVFET）是治疗不孕症不可缺少的手段，许多因素影响其成功率，如年龄、不孕原因、不孕年限、超促排卵方案、可移植优质胚胎数、子宫内膜容受性等[1,2]。而胚胎移植又是影响IVFET结局的最后一个短暂但又至关重要的步骤。许多生殖中心仍然沿用传统的盲操作胚胎移植方法，无法显示胚胎移植情况及位置。本文对我院生殖中心586例病人610个IVFET周期的资料进行回顾性分析，以探讨腹部超声引导下胚胎移植位置对IVFET结局的影响。 　　1 资料与方法 　　1.1 一般资料 　　2005年1月～2007年2月，在我院生殖中心实施IVFET病人586例，共进行610个胚胎移植周期，不包括融胚移植周期。病人年龄2