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原发性不孕女性宫腔镜下不完全子宫纵隔/弓形子宫畸形矫治术后体外受精的生殖结局

Reproductive outcome after IVF following hysteroscopic division of incomplete uterine septum/arcuate uterine anomaly in women with primary infertility.

作者信息

Abuzeid M, Ghourab G, Abuzeid O, Mitwally M, Ashraf M, Diamond M

机构信息

Division of Reproductive Endocrinology and Infertility, Department of OB/GYN, Hurley. Medical Center, Two Hurley Plaza, Suite 209, Flint, Michigan 48503, USA. Michigan State University College of Human Medicine, Flint Campus, USA. ; IVF Michigan PC, 3950 Rochester Road, Suite 2300, Rochester Hills, Michigan 48307, USA.

IVF Michigan PC, 3950 Rochester Road, Suite 2300, Rochester Hills, Michigan 48307, USA.

出版信息

Facts Views Vis Obgyn. 2014;6(4):194-202.

Abstract

OBJECTIVE

To determine reproductive outcome after in-vitro fertilization/embryo transfer (IVF-ET) in women with primary infertility following hysteroscopic septoplasty of incomplete uterine septum or arcuate uterine anomaly.

METHODS

This is a historical cohort study. The study group consisted of 156 consecutive patients who underwent a total of 221 cycles of IVF/ET following hysteroscopic septoplasty of an incomplete uterine septum or arcuate anomaly (Group 1). The control group included 196 consecutive patients with normal endometrial cavity on hysteroscopy who underwent a total of 369 cycles of IVF/ET (Group 2). The reproductive outcome after the first cycle of IVF-ET and the best reproductive outcome of all the cycles the patient underwent were calculated. In addition, we compared the reproductive outcome in the study group based on the type of the anomalies (septum versus arcuate).

RESULTS

In the first fresh cycle, following septoplasty, there were significantly higher clinical pregnancy and delivery rates in Group 1 (60.3% and 51.3% respectively) compared to Group 2 (38.8% and 33.2% respectively). However, there was no significant difference between the two groups in the clinical pregnancy (74.4% vs. 67.3%) or in the delivery (65.4% vs. 60.2%) rates per patient, respectively. There was no significant difference in the reproductive outcome after IVF-ET between patients who previously had arcuate uterine anomaly versus incomplete uterine septum.

CONCLUSION

Reproductive outcome of IVF-ET after hysteroscopic correction of incomplete uterine septum/arcuate uterine anomaly in women with primary infertility is no different from women with normal uterine cavity.

摘要

目的

确定不完全子宫纵隔或弓形子宫畸形患者在宫腔镜子宫纵隔切除术后进行体外受精/胚胎移植(IVF-ET)后的生殖结局。

方法

这是一项历史性队列研究。研究组由156例连续患者组成,这些患者在宫腔镜下对不完全子宫纵隔或弓形子宫畸形进行纵隔切除术后共进行了221个周期的IVF/ET(第1组)。对照组包括196例连续患者,这些患者宫腔镜检查显示子宫内膜腔正常,共进行了369个周期的IVF/ET(第2组)。计算IVF-ET第一个周期后的生殖结局以及患者所经历的所有周期中的最佳生殖结局。此外,我们根据畸形类型(纵隔与弓形)比较了研究组的生殖结局。

结果

在第一个新鲜周期中,纵隔切除术后,第1组的临床妊娠率和分娩率(分别为60.3%和51.3%)显著高于第2组(分别为38.8%和33.2%)。然而,两组患者的临床妊娠率(74.4%对67.3%)或分娩率(65.4%对60.2%)分别无显著差异。既往有弓形子宫畸形与不完全子宫纵隔的患者在IVF-ET后的生殖结局无显著差异。

结论

原发性不孕女性宫腔镜矫正不完全子宫纵隔/弓形子宫畸形后IVF-ET的生殖结局与子宫腔正常的女性无异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f10f/4286858/bed0fef7196d/FVVinObGyn-6-194-202-g001.jpg

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