辅助生殖技术后异位妊娠相关因素分析

摘要

Objective: To investigate the relevant factors of the ectopic pregnancy (EP) after assisted reproductive technology (ART).Methods: The patients who had EP after in vitro fertilization-embryo transfer (IVF-ET), intracytoplasmic sperm injection-embryo transfer (ICSI-ET), or frozen embryo transfer (FET) in this Center from November 2006 to June 2010 were retrospectively analyzed.Results: Among 4,219 treatment cycles, there were 1,773 pregnancies achieved (42. 02%). The incidence of EP was 2. 93 % (52/1,773). Among them, there were 46 cases of tubal pregnancy (88.46%), 3 cases of both intrauterine and tubal pregnancy (5. 77%), and 1 case each for cervical, cornual and ovarian pregnancy.In the three ways of ART, the incidence of EP of IVF-ET was significantly higher than that of ICSI-ET or FET (P<0. 05). There was no significant difference between ICSI-ET and FET. The risk factors for EP were history of ectopic pregnancy, pelvic surgery, endometriosis, and salpingitis. The number of embryos transferred was not significantly correlated with EP.Conclusions; Tubal factor was the major risk factor for ectopic pregnancy after ART treatment.%目的 探讨接受辅助生殖技术(ART)助孕后发生异位妊娠(EP)的相关因素. 方法 对我中心2006年11月至2010年6月接受体外受精-胚胎移植(IVF-ET)、卵胞浆内单精子注射-胚胎移植(ICSI-ET)、冻融胚胎移植(FET)治疗后发生EP的病例进行回顾性分析. 结果 4,219个周期获妊娠1,773例(42.02％),EP 52例,发生率2.93％ (52/1,773),其中单纯输卵管妊娠占88.46％(46/52),宫内外同时妊娠3例,发生率5.77％ (3/52),宫颈妊娠、卵巢妊娠、宫角妊娠各1例,发生率各占1.92％ (1/52)；3种ART方式发生率比较,IVF-ET显著高于ICSI-ET和FET(P＜0.05),ICSI-ET和FET无统计学差异；异位妊娠史、盆腔手术史、输卵管炎和子宫内膜异位症是发生EP的重要危险因素,胚胎移植数与EP发生无显著相关性. 结论 输卵管因素是ART后发生EP的主要因素.