Makrakis Evangelos, Hassiakos Dimitrios, Stathis Dimitrios, Vaxevanoglou Terpsi, Orfanoudaki Eleni, Pantos Konstantinos
Embryo ART Unit, Athens, Greece.
J Minim Invasive Gynecol. 2009 Mar-Apr;16(2):181-7. doi: 10.1016/j.jmig.2008.12.016.
To evaluate hysteroscopic findings and estimate the effect of hysteroscopy on achieving a pregnancy in women with a history of 2 implantation failures after in vitro fertilization (IVF).
Prospective observational and matched case control study.
II-2.
Private assisted reproduction units.
A total of 1475 patients with a history of 2 consecutive implantation failures after IVF who had a hysteroscopy were studied; there were 414 matched pairs of women with a similar history who either had or did not have a hysteroscopy.
Hysteroscopy (diagnostic or operative), IVF/intracytoplasmic sperm injection cycle.
Hysteroscopic findings, clinical pregnancy rate (CPR), and ongoing pregnancy rate (OPR) were measured. In all, 36.6% of the study population had abnormal hysteroscopic findings and 22.2% had unsuspected findings; women with abnormal hysteroscopic findings showed significantly increased CPR and increased OPR in a new IVF cycle compared with those with a normal hysteroscopy result. Women who had a hysteroscopy showed significantly increased CPR and OPR compared with matched control subjects who did not have the procedure. Hysteroscopy and appropriate therapy significantly increased the chances of achieving a subsequent clinical and ongoing pregnancy.
Women with 2 implantation failures after IVF had a remarkably high possibility for unsuspected abnormalities seen at hysteroscopy. Hysteroscopy could serve as a positive prognostic factor for achieving a subsequent pregnancy.
评估宫腔镜检查结果,并估计宫腔镜检查对既往体外受精(IVF)失败2次的女性实现妊娠的影响。
前瞻性观察性和匹配病例对照研究。
II-2。
私立辅助生殖机构。
共研究了1475例既往IVF连续失败2次且接受了宫腔镜检查的患者;有414对具有相似病史的女性配对,其中一些进行了宫腔镜检查,另一些未进行。
宫腔镜检查(诊断性或手术性)、IVF/卵胞浆内单精子注射周期。
测量宫腔镜检查结果、临床妊娠率(CPR)和持续妊娠率(OPR)。总体而言,36.6%的研究人群宫腔镜检查结果异常,22.2%有意外发现;与宫腔镜检查结果正常的女性相比,宫腔镜检查结果异常的女性在新的IVF周期中CPR显著增加,OPR也增加。与未进行宫腔镜检查的匹配对照受试者相比,进行了宫腔镜检查的女性CPR和OPR显著增加。宫腔镜检查及适当治疗显著增加了实现后续临床妊娠和持续妊娠的机会。
既往IVF失败2次的女性在宫腔镜检查时出现意外异常的可能性非常高。宫腔镜检查可作为实现后续妊娠的一个积极预后因素。