Silberstein Tali, Weitzen Sherry, Frankfurter David, Trimarchi James R, Keefe David L, Plosker Shayne M
Division of Biology and Medicine, Women and Infants' Hospital of Rhode Island, Brown Medical School, Providence 02905, USA.
Fertil Steril. 2004 Nov;82(5):1402-6. doi: 10.1016/j.fertnstert.2004.04.044.
To assess the impact of cannulation of a resistant cervical os with the outer malleable sheath of a double-lumen, soft ET catheter on IVF-ET outcomes.
Retrospective cohort study.
University-based IVF center.
PATIENT(S): One hundred forty-two patients undergoing 142 ETs.
INTERVENTION(S): Trial ultrasound-guided ET at all transfers, leaving the malleable outer sheath in situ when the soft inner catheter could not negotiate the internal os.
MAIN OUTCOME MEASURE(S): Implantation rate and clinical pregnancy rate.
RESULT(S): In 102 ETs (71.8%), the soft inner sheath easily negotiated the internal os (group 1). Forty ETs (28.2%) required cannulation of resistant internal ora with the outer sheath of the trial catheter (group 2). Implantation rates (35% vs. 32% in groups 1 and 2, respectively) and clinical pregnancy rates (50% vs. 45%) were not significantly different between groups. Blood was present on the transfer catheter after ET more frequently in group 2 than in group 1 (55% vs. 15%); however, neither the implantation rate nor the clinical pregnancy rate were affected by the presence of blood.
CONCLUSION(S): Cannulation of a resistant internal os by the malleable outer sheath and blood on the transfer catheter after ET do not have an adverse effect on implantation rate or clinical pregnancy rate.
评估使用双腔软质胚胎移植(ET)导管的可塑形外鞘对宫颈内口阻力较大的患者进行插管操作对体外受精-胚胎移植(IVF-ET)结局的影响。
回顾性队列研究。
大学附属医院的IVF中心。
142例接受142次胚胎移植的患者。
所有移植均在超声引导下进行胚胎移植试验,当软质内导管无法通过宫颈内口时,将可塑形外鞘留在原位。
着床率和临床妊娠率。
在102次胚胎移植(71.8%)中,软质内鞘轻松通过宫颈内口(第1组)。40次胚胎移植(28.2%)需要使用试验导管的外鞘对阻力较大的宫颈内口进行插管(第2组)。第1组和第2组的着床率(分别为35%和32%)和临床妊娠率(分别为50%和45%)无显著差异。胚胎移植后,第2组移植导管上出现血液的频率高于第1组(55%对15%);然而,血液的出现既不影响着床率也不影响临床妊娠率。
可塑形外鞘对阻力较大的宫颈内口进行插管以及胚胎移植后移植导管上出现血液对着床率或临床妊娠率没有不利影响。