子宫内膜息肉患者IVF周期妊娠结局的临床分析

摘要

目的 探讨子宫内膜息肉(EP)与IVF助孕妊娠结局的关系. 方法 回顾性分析2014年1月至2016年12月在本院生殖专科医院行IVF-ET助孕、术前行宫腔镜检查的536个周期的临床资料,根据宫腔镜检查情况分为EP组(363个周期)和正常内膜组(1 73个周期),其中EP组又根据促排卵方案的不同分为长方案组(235个周期)和超长方案组(128个周期),分析各组患者的一般资料、实验室及临床数据的差异. 结果 EP组移植日子宫内膜厚度显著高于正常内膜组(P＜0.001);临床妊娠率、胚胎种植率、早期流产率、异位妊娠率、活产率等比较没有显著性差异(P＞0.05);生化妊娠率EP组显著高于正常内膜组(P＜0.05).EP患者中,与长方案组比较,超长方案组Gn总量显著增多(P＜0.001)、HCG日E2显著降低(P＜0.05)、获卵数显著减少(P＜0.001)、优质胚胎率显著降低(P＜0.05);临床妊娠率、生化妊娠率、胚胎种植率、早期流产率、异位妊娠率及活产率等组间比较均无显著性差异(P＞0.05). 结论 EP患者宫腔镜治疗后与正常子宫内膜患者的IVF结局相似.EP患者行超长方案与长方案促排卵的IVF结局相似.%Objective:To investigate the relationship between endometrial polyps and IVF outcome.Methods:The clinical data of 536 patients with hysteroscopy prior to cycle in Reproductive Medicine hospital of the First Hospital of Lanzhou University from January 2014 to December 2016 were retrospectively analyzed.The patients were divided into three groups according the hysteroscopy results:endometrial polyp(EP)group(n=363)and normal endometrial group(n=173).The EP group was subdivided into long protocol group(n=235)and super-long protocol group(n=128).Results:The endometrial thickness on embryo transfer day in EP group was significantly thicker than that in normal endometrium group(P＜0.001).There were no significant differences in clinical pregnancy rate,implantation rate,early abortion rate,ectopic pregnancy rate and live birth rate between the endometrial group and normal endometrial group(P＞0.05),but the biochemical pregnancy rate of the EP group was significantly higher(P＜0.05).There were no significant differences in clinical pregnancy rate,biochemical pregnancy rate,implantation rate,early abortion rate,ectopic pregnancy rate and live birth rate between long protocol group and super-long protocol group.However,the amount of Gn used was significantly more(P＜ 0.001);serum E2 level was significantly lower (P ＜ 0.05);the number of oocytes retrieved was significantly less(P＜0.001);and high-quality embryo rate was significantly lower(P＜0.05)in super long protocol group.Conclusions:The similar IVF outcome as normal endometrial patients can be obtained in the patients with endometrial polyps after hysteroscopic treatment.The IVF outcome was similar between long protocol and super-long protocol in endometrial polyps patients.